Provider Demographics
NPI:1336272624
Name:DOERING, DAVID FREDERICK (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:FREDERICK
Last Name:DOERING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 W LINEBAUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7753
Mailing Address - Country:US
Mailing Address - Phone:813-933-5365
Mailing Address - Fax:813-933-0480
Practice Address - Street 1:1201 W LINEBAUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7753
Practice Address - Country:US
Practice Address - Phone:813-933-5365
Practice Address - Fax:813-933-0480
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL100251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice