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Organization
PREMIER DENTAL & IMPLANT STUDIO
Active
Organization
PREMIER DENTAL & IMPLANT STUDIO
Active
Parent organization
COLLIER ORAL SURGERY & IMPLANT CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLLIER ORAL SURGERY & IMPLANT CENTER
Authorized official
DIANA COLMENARES (PRACTICE MANAGER)
(239) 254-9933
Entity
Organization
Contact information
Practice address
20321 GRANDE OAK SHOPPES BLVD STE 316, ESTERO, FL 33928-7697
(239) 992-0325
(239) 992-0329
Mailing address
20321 GRANDE OAK SHOPPES BLVD STE 316, ESTERO, FL 33928-7697
(239) 992-0325
(239) 992-0329
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN15549
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN15449
FL
Other
Enumeration date
05/01/2014
Last updated
05/01/2014
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