Healthcare Provider Details

I. General information

NPI: 1679905103
Provider Name (Legal Business Name): LUCIA GREER D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2013
Last Update Date: 11/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 SE 8TH TER STE A
CAPE CORAL FL
33990-3289
US

IV. Provider business mailing address

822 BAHIA DEL SOL DR B
RUSKIN FL
33570-3081
US

V. Phone/Fax

Practice location:
  • Phone: 239-574-2000
  • Fax:
Mailing address:
  • Phone: 646-477-0427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN20338
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: