MEDICARE: CATLIN LEGACY DENTAL STUDIO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1457207466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATLIN LEGACY DENTAL STUDIO

Provider Business Mailing Address
First Line	:	825 CYPRESS LAKE CIR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-6013
Country	:	US
Telephone Number	:	239-823-9026
Fax Number	:

Provider Business Practice Location Address
First Line	:	12630 NEW BRITTANY BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-3627
Country	:	US
Telephone Number	:	239-823-9026
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	DR. JAREN O CATLIN
Credential	:	DMD
Telephone Number	:	239-823-9026

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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