| Bonita Palm Dental | |
|
9776 Bonita Beach Rd Se Ste 202a Bonita Springs FL 34135-4775 | |
| (239) 221-7079 | |
| Not Available |
| Full Name | Bonita Palm Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 9776 Bonita Beach Rd Se Ste 202a, Bonita Springs, Florida |
| Authorized Official Name and Position | Maximus Zand (DENTIST) |
| Authorized Official Contact | 2398100821 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bonita Palm Dental 9776 Bonita Beach Rd Se Ste 202a Bonita Springs FL 34135-4775 Ph: (239) 221-7079 | Bonita Palm Dental 9776 Bonita Beach Rd Se Ste 202a Bonita Springs FL 34135-4775 Ph: (239) 221-7079 |
| NPI Number | 1235702887 |
|---|---|
| Provider Enumeration Date | 07/21/2021 |
| Last Update Date | 07/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235702887 | NPI | - | NPPES |
| 0026911 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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