Organization
DEIRDER M CAMPBELL
Active
Other names
Colonial Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEIRDRE M CAMPBELL D.M.D. (OWNER)
(239) 936-7400
Entity
Organization
Contact information
Practice address
4447 CAMINO REAL WAY, FORT MYERS, FL 33966-1019
(239) 936-7400
(239) 936-7696
Mailing address
4447 CAMINO REAL WAY, FORT MYERS, FL 33966-1019
(239) 936-7400
(239) 936-7696
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN16533
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4131731
BC/BS
FL
01
—
62322
BC/BS
FL
Enumeration date
03/06/2008
Last updated
03/06/2008
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