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Organization

FT MYERS DENTAL SERVICE PA

Active
Other names
Main Street Orthodontics of Ft Myers
Organization subpart
No

Provider details

NPI number
Authorized official
MELODY PARRISH (DIRECTOR OF OPERATIONS)
(305) 274-2499
Entity
Organization

Contact information

Practice address
6150 DIAMOND CENTRE CT, BLDG 300, SUITE 2, FORT MYERS, FL 33912-4365
(239) 768-2485
(239) 433-5557
Mailing address
6150 DIAMOND CENTER COURT, BLDG 300, SUITE 2, FT. MYERS, FL 33912
(239) 768-2485
(239) 433-5557

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary

Other

Enumeration date
08/15/2007
Last updated
08/15/2007
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