| Fantasea Pediatric Dentistry | |
|
1890 Sw Health Pkwy Ste 104 Naples FL 34109-0473 | |
| (239) 594-1171 | |
| Not Available |
| Full Name | Fantasea Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1890 Sw Health Pkwy Ste 104, Naples, Florida |
| Authorized Official Name and Position | Joana Lastres (OWNER) |
| Authorized Official Contact | 2395941171 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fantasea Pediatric Dentistry 1890 Sw Health Pkwy Ste 104 Naples FL 34109-0473 Ph: (239) 594-1171 | Fantasea Pediatric Dentistry 1890 Sw Health Pkwy Ste 104 Naples FL 34109-0473 Ph: (239) 594-1171 |
| NPI Number | 1457874588 |
|---|---|
| Provider Enumeration Date | 07/20/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457874588 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DN21762 (Florida) | Primary |
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