Organization
ISLAND COAST DENTISTRY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY ROBERT SKUPNY DMD (PRESIDENT)
(352) 246-3177
Entity
Organization
Contact information
Practice address
1044 CASTELLO DR, 110, NAPLES, FL 34103
(239) 261-5566
Mailing address
20570 GROVELINE CT, ESTERO, FL 33928
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18097
FL
Other
Enumeration date
11/12/2010
Last updated
11/12/2010
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