C R Fort Dmd Plc | |
330 E Broadway St Fort Meade FL 33841-3012 | |
(863) 285-7121 | |
(863) 285-8648 |
Full Name | C R Fort Dmd Plc |
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Speciality | Dentist - General Practice |
Location | 330 E Broadway St, Fort Meade, Florida |
Authorized Official Name and Position | Charles Robert Fort (OWNER) |
Authorized Official Contact | 8632857121 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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C R Fort Dmd Plc 330 E Broadway St Fort Meade FL 33841-3012 Ph: (863) 285-7121 | C R Fort Dmd Plc 330 E Broadway St Fort Meade FL 33841-3012 Ph: (863) 285-7121 |
NPI Number | 1831443258 |
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Provider Enumeration Date | 11/07/2012 |
Last Update Date | 11/07/2012 |
Identifier | Type | State | Issuer |
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1831443258 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 8002 (Florida) | Primary |