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Organization
FREEDOM DENTAL OF FORT MYERS PA
Active
Organization
FREEDOM DENTAL OF FORT MYERS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH CHARLES VANDERBOSCH DMD (PRESIDENT)
(239) 776-9512
Entity
Organization
Contact information
Practice address
14150 METROPOLIS AVE STE 1, FORT MYERS, FL 33912-4345
(239) 561-9325
(239) 561-8327
Mailing address
14150 METROPOLIS AVE STE 1, FORT MYERS, FL 33912-4345
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/04/2020
Last updated
03/16/2021
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