Healthcare Provider Details

I. General information

NPI: 1508784752
Provider Name (Legal Business Name): PARADISE COAST DENTAL ARTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8590 COLLIER BLVD STE 102
NAPLES FL
34114-2502
US

IV. Provider business mailing address

397 DEAUVILLE LOOP
NAPLES FL
34114-8343
US

V. Phone/Fax

Practice location:
  • Phone: 801-896-3447
  • Fax:
Mailing address:
  • Phone: 609-319-5922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. BRIAN RUSSELL GARCIA
Title or Position: OWNER
Credential: DMD
Phone: 609-319-5922