Organization
FLORIDA DENTAL PROFESSIONALS, P.A.
Active
Parent organization
FLORIDA DENTAL PROFESSIONALS, P.A.
Other names
Imperial Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
FLORIDA DENTAL PROFESSIONALS, P.A.
Authorized official
COURTNEY MONTEITH (CREDENTIALING COORDINATOR)
(217) 540-8306
Entity
Organization
Contact information
Practice address
27821 S TAMIAMI TRL STE 1, BONITA SPRINGS, FL 34134-4238
(239) 947-6900
Mailing address
27821 S TAMIAMI TRL STE 1, BONITA SPRINGS, FL 34134-4238
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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