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Organization
TOWNCARE DENTAL OF BONITA SPRINGS, P.A
Active
Organization
TOWNCARE DENTAL OF BONITA SPRINGS, P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE GOMEZ (PROVIDER RELATIONS SPECIALIST)
(305) 274-2499
Entity
Organization
Contact information
Practice address
16565 VANDERBILT DR, BONITA SPRINGS, FL 34134-7552
(239) 498-6780
Mailing address
13195 SW 134 ST, 2ND FLOOR, MIAMI, FL 33186
(305) 274-2499
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
02/19/2014
Last updated
08/06/2014
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