Organization
FLORIDA DENTAL PROFESSIONALS, P.A.
Active
Parent organization
FLORIDA DENTAL PROFESSIONALS, P.A.
Other names
Dentistry of Fort Myers
Organization subpart
Yes
Provider details
NPI number
Legal business name
FLORIDA DENTAL PROFESSIONALS, P.A.
Authorized official
HILLARY THULL (CREDENTIALING COORDINATOR)
(217) 540-8946
Entity
Organization
Contact information
Practice address
11609 S CLEVELAND AVE STE 24, FORT MYERS, FL 33907-2869
(239) 772-3700
Mailing address
11609 S CLEVELAND AVE STE 24, FORT MYERS, FL 33907-2869
(239) 772-3700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/03/2022
Last updated
10/24/2023
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