Provider Demographics
NPI:1588047468
Name:TITOV, VOLHA (DDS)
Entity type:Individual
Prefix:DR
First Name:VOLHA
Middle Name:
Last Name:TITOV
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:VOLHA
Other - Middle Name:
Other - Last Name:BUDZINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1302 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-5042
Mailing Address - Country:US
Mailing Address - Phone:386-328-0108
Mailing Address - Fax:386-325-1086
Practice Address - Street 1:410 NE WALDO RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32641
Practice Address - Country:US
Practice Address - Phone:352-375-3790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-09
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21424122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist