Provider Demographics
NPI:1396869525
Name:SPOTO, GERALD L (DDS, PA)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:L
Last Name:SPOTO
Suffix:
Gender:M
Credentials:DDS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5420 WEBB RD
Mailing Address - Street 2:STE A-2
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-3250
Mailing Address - Country:US
Mailing Address - Phone:813-884-3287
Mailing Address - Fax:813-884-6977
Practice Address - Street 1:5420 WEBB RD
Practice Address - Street 2:STE A-2
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-3250
Practice Address - Country:US
Practice Address - Phone:813-884-3287
Practice Address - Fax:813-884-6977
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL53411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice