Healthcare Provider Details

I. General information

NPI: 1841338399
Provider Name (Legal Business Name): WILLIAM EDWARD STARNER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2007
Last Update Date: 03/22/2022
Certification Date: 03/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18990 S TAMIAMI TRL STE 110
FORT MYERS FL
33908-4737
US

IV. Provider business mailing address

23452 SANABRIA LOOP
BONITA SPRINGS FL
34135-5380
US

V. Phone/Fax

Practice location:
  • Phone: 239-482-2296
  • Fax: 239-482-7732
Mailing address:
  • Phone: 518-588-9788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number33124
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN17028
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: