Organization
HERSTON DENTAL SERVICES, PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELODY LYNN HERSTON D.M.D. (PRESIDENT)
(941) 255-3700
Entity
Organization
Contact information
Practice address
4161 TAMIAMI TRL, SUITE 803, PORT CHARLOTTE, FL 33952-9204
(941) 255-3700
(941) 764-0812
Mailing address
4161 TAMIAMI TRL, SUITE 803, PORT CHARLOTTE, FL 33952-9204
(941) 255-3700
(941) 764-0812
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN 16359
FL
Other
Enumeration date
05/21/2007
Last updated
08/22/2020
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