| Colonial Dental Group | |
|
4447 Camino Real Way Fort Myers FL 33966-1019 | |
| (239) 936-7400 | |
| (239) 936-7696 |
| Full Name | Colonial Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 4447 Camino Real Way, Fort Myers, Florida |
| Authorized Official Name and Position | Deirdre M Campbell (OWNER) |
| Authorized Official Contact | 2399367400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Colonial Dental Group 4447 Camino Real Way Fort Myers FL 33966-1019 Ph: (239) 936-7400 | Colonial Dental Group 4447 Camino Real Way Fort Myers FL 33966-1019 Ph: (239) 936-7400 |
| NPI Number | 1669642641 |
|---|---|
| Provider Enumeration Date | 03/06/2008 |
| Last Update Date | 03/06/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669642641 | NPI | - | NPPES |
| 62322 | Other | FL | BC/BS |
| 4131731 | Other | FL | BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN16533 (Florida) | Primary |
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