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General NPI Number Information
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NPI Number | 1023397163
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Entity Type | Individual
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Provider Name | CHRISTOPHER ANDREW WIDMER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/08/2011
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Last Update Date | 11/20/2018
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Provider Practice Location Address
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Address Line | 4959 CASTELLO DR
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City | NAPLES
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State | FL
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Zip | 34103
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Country | US
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Telephone | 239-262-2677
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Fax | 239-261-2670
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Provider Business Mailing Address
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Address Line | 1735 OAKES BLVD
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City | NAPLES
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State | FL
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Zip | 34119-8658
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Country | US
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Telephone | 301-801-6428
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 15101
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN20965
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License Number State | FL
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