Individual
DR. CHARLES ROBERT FORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
330 EAST BROADWAY STREET, FORT MEADE, FL 33841
(863) 285-7121
(863) 285-8648
Mailing address
330 EAST BROADWAY STREET, FORT MEADE, FL 33841
(863) 285-7121
(863) 285-8648
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8002
FL
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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