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General NPI Number Information
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NPI Number | 1003101437
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Entity Type | Organization
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Legal Business Name | COLLIER DENTAL STUDIO
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Dates
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Enumeration Date | 06/14/2011
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Last Update Date | 09/02/2011
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Provider Practice Location Address
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Address Line | 3400 TAMIAMI TRL N SUITE 301
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City | NAPLES
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State | FL
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Zip | 34103-3717
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Country | US
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Telephone | 239-234-6368
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Fax | 239-384-9291
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Provider Business Mailing Address
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Address Line | 3400 TAMIAMI TRL N SUITE 301
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City | NAPLES
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State | FL
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Zip | 34103-3717
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Country | US
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Telephone | 239-234-6368
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Fax | 239-384-9291
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAWN M ARENA
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Credential | DDS
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Telephone | 239-234-6368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN14254
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License Number State | FL
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