Individual
JOSEPH MEJIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1105 SE 47TH TER, CAPE CORAL, FL 33904-9166
(239) 542-4626
Mailing address
1105 SE 47TH TER, CAPE CORAL, FL 33904-9166
(407) 914-6340
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
23287
FL
1223G0001X
General Practice Dentistry
23287
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2015
Last updated
08/24/2022
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