Polliwog Dental LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN18670 Issued in FL

Legal business name

POLLIWOG DENTAL LLC

Practice address

255 SE 17TH St
Ocala, FL 34471

Phone

(352) 274-9731

Fax

(352) 274-9731

NPI assigned

Aug 17, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael A Tarver, DMD

Title

Owner

Phone

(863) 899-1617

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344988800000",
    "number": "1588944987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 SE 17TH ST",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "34471",
            "telephone_number": "352-274-9731",
            "fax_number": "352-274-9731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 SE 17TH ST",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "34471",
            "telephone_number": "352-274-9731",
            "fax_number": "352-274-9731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLLIWOG DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-17",
        "last_updated": "2012-08-15",
        "status": "A",
        "authorized_official_last_name": "TARVER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-899-1617",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN18670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kwanda Poitier
• Peter J. Polack, M.D.
• Alison Jill Polish, M.A.
• Keith W Pollaci, CAP
• Stephen Watson Pollard, MD
• Kathleen Faith Polston, OTR/L
• Kathryn Mar Jip Pomakis, OD
• Carol Lynn Poole, LCSW
• Djuna Poole, HOMEMAKER/COMPANION
• Donna Sherry Poole, RN

• Pediatric Dentistry in Ocala, FL
• Providers in Ocala, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.