Organization
CARILLON COSMETIC & GENERAL DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR VERGARA DMD (OWNER - OPERATING DENTIST)
(239) 595-0821
Entity
Organization
Contact information
Practice address
13180 LIVINGSTON RD BLDG 100, SUITE # 106, NAPLES, FL 34109-3871
(239) 263-0912
(239) 263-0925
Mailing address
13180 LIVINGSTON RD BLDG 100, SUITE # 106, NAPLES, FL 34109-3871
(239) 263-0912
(239) 263-0925
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16089
FL
Other
Enumeration date
01/05/2016
Last updated
01/05/2016
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