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General NPI Number Information
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NPI Number | 1033892021
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Entity Type | Organization
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Legal Business Name | LITTLE BIG SMILES PLLC
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Dates
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Enumeration Date | 08/08/2023
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 9377 6 MILE CYPRESS PKWY STE 120
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City | FORT MYERS
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State | FL
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Zip | 33966-6538
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Country | US
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Telephone | 239-500-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 4312 WATERCOLOR WAY
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City | FORT MYERS
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State | FL
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Zip | 33966-1180
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Country | US
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Telephone | 305-951-9732
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Fax |
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Authorized Official
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Title or Position | DENTIST/MANAGER
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Name | DR. LEANET ASCUNCE
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Credential | DMD
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Telephone | 305-951-9732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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