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Organization

COLLIER HEALTH SERVICES INC

Active
Other names
CHS-UF Pediatric Dental Center
Organization subpart
No

Provider details

NPI number
Authorized official
SANDRA STEELE (CHIEF FINANCIAL OFFICER)
(239) 658-3003
Entity
Organization

Contact information

Practice address
1454 MADISON AVE W, IMMOKALEE, FL 34142-2200
(239) 658-3064
(239) 658-3175
Mailing address
7007 LELY CULTURAL PKWY, EDISON COLLEGE BUILDING L, NAPLES, FL 34113-8976
(239) 775-3052
(239) 775-7035

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
1223P0221X
Pediatric Dentistry
Primary
1223P0300X
Periodontics
124Q00000X
Dental Hygienist
126800000X
Dental Assistant
261QF0400X
Federally Qualified Health Center (FQHC)

Other

Enumeration date
09/18/2008
Last updated
11/10/2021
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