Individual
JASON SPEARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4300 KINGS HWY, SUITE 500, PORT CHARLOTTE, FL 33980-2917
(239) 344-2337
(941) 629-2365
Mailing address
PO BOX 1357, FORT MYERS, FL 33902-1357
(239) 278-3600
(239) 226-4650
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN 20514
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011672400
—
FL
Enumeration date
03/13/2014
Last updated
05/04/2017
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