Organization
BONITA SPRINGS EDC MANAGEMENT LLC
Active
Parent organization
BONITA SPRINGS EDC MANAGEMENT LLC
Other names
Emergency Dental Care USA
Organization subpart
Yes
Provider details
NPI number
Legal business name
BONITA SPRINGS EDC MANAGEMENT LLC
Authorized official
MICHAEL OBENG (MANAGER)
(402) 981-4136
Entity
Organization
Contact information
Practice address
8553 W LINEBAUGH AVE, TAMPA, FL 33625-3731
(813) 926-9228
Mailing address
PO BOX 788, BOYS TOWN, NE 68010-0788
(402) 658-4687
(402) 597-3643
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
11/07/2018
Last updated
08/03/2023
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