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Organization
DENTAL SPECIALTY CENTER OF CAPE CORAL
Active
Organization
DENTAL SPECIALTY CENTER OF CAPE CORAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE GOMEZ (CREDENTIALING COORDINATOR)
(305) 274-2499
Entity
Organization
Contact information
Practice address
821 CAPE CORAL PKWY W UNIT 3-5, CAPE CORAL, FL 33914-7420
(305) 274-2499
Mailing address
821 CAPE CORAL PKWY W UNIT 3-5, CAPE CORAL, FL 33914-7420
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223P0300X
Periodontics
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
03/06/2017
Last updated
03/06/2017
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