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General NPI Number Information
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NPI Number | 1124715362
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Entity Type | Individual
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Provider Name | KARA LIEN ECKSTEIN
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Gender | Female
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Dates
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Enumeration Date | 04/19/2023
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 7505 GRAND LELY DR
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City | NAPLES
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State | FL
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Zip | 34113-1753
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Country | US
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Telephone | 452-392-0239
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Fax |
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Provider Business Mailing Address
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Address Line | 7870 OLIVER RD
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City | SEMINOLE
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State | FL
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Zip | 33777-3009
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Country | US
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Telephone | 727-254-3938
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DRPM2628
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN28573
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License Number State | FL
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