Organization
DENTAL SPECIALTY CENTER OF CAPE CORAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE GOMEZ (CREDENTIALING COORDINATOR)
(305) 274-2499
Entity
Organization
Contact information
Practice address
821 CAPE CORAL PKWY W UNIT 3-5, CAPE CORAL, FL 33914-7420
(305) 274-2499
Mailing address
821 CAPE CORAL PKWY W UNIT 3-5, CAPE CORAL, FL 33914-7420
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223P0300X
Periodontics
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
03/06/2017
Last updated
03/06/2017
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