FREEDOM DENTAL OF FORT MYERS PA NPI 1609471747

NPI Information

NPI: 1609471747
Provider Name: FREEDOM DENTAL OF FORT MYERS PA
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
14150 METROPOLIS AVE STE 1
FORT MYERS, FL
ZIP 33912
Phone: (239) 561-9325
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FREEDOM DENTAL OF FORT MYERS PA is a dental clinic center in Fort Myers, FL. FREEDOM DENTAL OF FORT MYERS PA NPI is 1609471747. The provider is registered as an organization entity type.

The provider's business location address is:

14150 METROPOLIS AVE STE 1
FORT MYERS, FL
ZIP 33912-345
Phone: (239) 561-9325
Fax: (239) 561-8327

The provider's authorized official is Joseph Charles Vanderbosch .
The authorized official title is President and has the following contact phone number (239) 776-9512.

The enumeration date for this NPI number is 12/4/2020 and was last updated on 3/16/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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