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General NPI Number Information
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NPI Number | 1174614465
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Entity Type | Individual
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Provider Name | LAUREN M GOVERNALE DMD
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Gender | Female
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 05/03/2016
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Provider Practice Location Address
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Address Line | 7007 LELY CULTURAL PKWY
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City | NAPLES
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State | FL
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Zip | 34113-8976
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Country | US
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Telephone | 239-775-3052
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Fax | 239-775-7035
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Provider Business Mailing Address
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Address Line | 1907 COUNTESS CT
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City | NAPLES
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State | FL
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Zip | 34110-1005
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Country | US
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Telephone | 239-592-7609
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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 | DN10507
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License Number State | FL
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