Provider Demographics
NPI:1548323546
Name:MICHAEL D INSOFT DMD PA
Entity type:Organization
Organization Name:MICHAEL D INSOFT DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:INSOFT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:727-384-4511
Mailing Address - Street 1:6700 CROSSWINDS DR N
Mailing Address - Street 2:SUITE 300B
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-8602
Mailing Address - Country:US
Mailing Address - Phone:727-384-4511
Mailing Address - Fax:727-341-0610
Practice Address - Street 1:6700 CROSSWINDS DR N
Practice Address - Street 2:SUITE 300B
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-8602
Practice Address - Country:US
Practice Address - Phone:727-384-4511
Practice Address - Fax:727-341-0610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN127251223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty