| Main Street Children's Dentistry Of Ft. Myers | |
|
6150 Diamond Centre Ct Bldg 300, Suite 2 Fort Myers FL 33912-4365 | |
| (239) 768-2485 | |
| Not Available |
| Full Name | Main Street Children's Dentistry Of Ft. Myers |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6150 Diamond Centre Ct, Fort Myers, 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 Ft. Myers 13195 Sw 134th St 2nd Floor Miami FL 33186-4461 Ph: (305) 274-2499 | Main Street Children's Dentistry Of Ft. Myers 6150 Diamond Centre Ct Bldg 300, Suite 2 Fort Myers FL 33912-4365 Ph: (239) 768-2485 |
| NPI Number | 1437479169 |
|---|---|
| Provider Enumeration Date | 06/04/2010 |
| Last Update Date | 07/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437479169 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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