Healthcare Provider Details

I. General information

NPI: 1184782336
Provider Name (Legal Business Name): DOMINIC A SABATINI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 04/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2095 9TH ST N
NAPLES FL
34102-4806
US

IV. Provider business mailing address

2095 9TH ST N
NAPLES FL
34102-4806
US

V. Phone/Fax

Practice location:
  • Phone: 239-430-1515
  • Fax: 239-430-1518
Mailing address:
  • Phone: 239-430-1515
  • Fax: 239-430-1518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN17728
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS031498L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: