Provider Demographics
NPI:1588871347
Name:TINDELL, MARC S (DMD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:S
Last Name:TINDELL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:880 MANDALAY AVE
Mailing Address - Street 2:N509
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33767-1242
Mailing Address - Country:US
Mailing Address - Phone:813-961-1727
Mailing Address - Fax:813-968-7220
Practice Address - Street 1:801 W FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-3424
Practice Address - Country:US
Practice Address - Phone:813-961-1727
Practice Address - Fax:813-968-7220
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL87861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice