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Organization
PICASSO AESTHETIC AND COSMETIC DENTAL SPA PA
Active
Organization
PICASSO AESTHETIC AND COSMETIC DENTAL SPA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY RUBIN (PRESIDENT)
(239) 370-3343
Entity
Organization
Contact information
Practice address
3660 CENTRAL AVE STE 14, FORT MYERS, FL 33901-8258
(239) 401-2799
(239) 320-3288
Mailing address
20843 THISTLE LEAF LN, ESTERO, FL 33928-4082
(239) 401-2799
(239) 320-3288
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DN12852
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
07/27/2012
Last updated
03/05/2026
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