Organization
FORT MYERS DENTAL ARTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN CHOURAQUI DMD (OWNER)
(239) 936-3030
Entity
Organization
Contact information
Practice address
12530 NEW BRITTANY BLVD, FORT MYERS, FL 33907-3624
(239) 936-3030
(239) 418-0313
Mailing address
12530 NEW BRITTANY BLVD, FORT MYERS, FL 33907-3624
(239) 936-3030
(239) 418-0313
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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