| Dental Designs Of Fort Myers, Llc | |
|
3230 Forum Blvd Ste 501 Fort Myers FL 33905-5580 | |
| (239) 628-1300 | |
| (239) 262-7970 |
| Full Name | Dental Designs Of Fort Myers, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3230 Forum Blvd Ste 501, Fort Myers, Florida |
| Authorized Official Name and Position | Ramon Padilla (OWNER/MGR) |
| Authorized Official Contact | 2396281300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Designs Of Fort Myers, Llc 3230 Forum Blvd Ste 501 Fort Myers FL 33905-5580 Ph: (239) 628-1300 | Dental Designs Of Fort Myers, Llc 3230 Forum Blvd Ste 501 Fort Myers FL 33905-5580 Ph: (239) 628-1300 |
| NPI Number | 1952540270 |
|---|---|
| Provider Enumeration Date | 02/10/2009 |
| Last Update Date | 04/26/2018 |
| Medicare PECOS PAC ID | 7719221142 |
|---|---|
| Medicare Enrollment ID | O20181211003422 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952540270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 16414 (Florida) | Primary |
| Provider Name | Ramon C Padilla |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1356569024 PECOS PAC ID: 2860757531 Enrollment ID: I20180530000856 |
| Provider Name | Kelli Orcutt |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1063907087 PECOS PAC ID: 6507199866 Enrollment ID: I20190531001833 |
| Provider Name | Juan Fajardo |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1275150799 PECOS PAC ID: 6406259852 Enrollment ID: I20210723000282 |
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