| Main Street Children's Dentistry Of Bonita Springs | |
|
16565 Vanderbilt Dr Bonita Springs FL 34134-7552 | |
| (239) 322-1262 | |
| Not Available |
| Full Name | Main Street Children's Dentistry Of Bonita Springs |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 16565 Vanderbilt Dr, Bonita Springs, Florida |
| Authorized Official Name and Position | Melvyn Gober (CEO) |
| Authorized Official Contact | 3052742499 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Children's Dentistry Of Bonita Springs 13195 Sw 134th St 2nd Floor Miami FL 33186-4461 Ph: (305) 274-2499 | Main Street Children's Dentistry Of Bonita Springs 16565 Vanderbilt Dr Bonita Springs FL 34134-7552 Ph: (239) 322-1262 |
| NPI Number | 1477864528 |
|---|---|
| Provider Enumeration Date | 06/23/2010 |
| Last Update Date | 07/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477864528 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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