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General NPI Number Information
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NPI Number | 1326396748
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Entity Type | Organization
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Legal Business Name | LESTER GIL DDS, PA
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 11399 OVERSEAS HWY STE 5
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City | MARATHON
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State | FL
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Zip | 33050-3412
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Country | US
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Telephone | 305-247-5161
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Fax | 305-247-5120
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Provider Business Mailing Address
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Address Line | 11399 OVERSEAS HWY SUITE#5
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City | MARATHON
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State | FL
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Zip | 33050
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Country | US
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Telephone | 305-247-5161
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Fax | 305-247-5120
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Authorized Official
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Title or Position | PRESIDENT/DR
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Name | DR. LESTER O GIL
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Credential | DDS
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Telephone | 305-247-5161
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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 | DN18301
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License Number State | FL
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