Organization
VALLO FT MYERS PLLC THE DENTAL BOUTIQUE FORT MYERS
Active
Other names
The Dental Boutique Fort Myers
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL COBOS (OPERATIONS OFFICER)
(773) 398-5423
Entity
Organization
Contact information
Practice address
5100 S CLEVELAND AVE FL 33907, FORT MYERS, FL 33907-2189
(239) 327-0862
Mailing address
5100 S CLEVELAND AVE FL 33907, FORT MYERS, FL 33907-2189
(239) 327-0862
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/08/2025
Last updated
05/08/2025
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