| Herston Dental Services, Pl | |
|
4161 Tamiami Trl Suite 803 Port Charlotte FL 33952-9204 | |
| (941) 255-3700 | |
| (941) 764-0812 |
| Full Name | Herston Dental Services, Pl |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4161 Tamiami Trl, Port Charlotte, Florida |
| Authorized Official Name and Position | Melody Lynn Herston (PRESIDENT) |
| Authorized Official Contact | 9412553700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Herston Dental Services, Pl 4161 Tamiami Trl Suite 803 Port Charlotte FL 33952-9204 Ph: (941) 255-3700 | Herston Dental Services, Pl 4161 Tamiami Trl Suite 803 Port Charlotte FL 33952-9204 Ph: (941) 255-3700 |
| NPI Number | 1285843110 |
|---|---|
| Provider Enumeration Date | 05/21/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285843110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN 16359 (Florida) | Primary |
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