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General NPI Number Information
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NPI Number | 1336184456
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Entity Type | Organization
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Legal Business Name | LANA'S DENTAL CARE, P.A.
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2515 NORTHBROOKE PLAZA DR SUITE 100
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City | NAPLES
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State | FL
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Zip | 34119-7961
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Country | US
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Telephone | 239-593-6488
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Fax | 239-593-0549
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Provider Business Mailing Address
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Address Line | 2515 NORTHBROOKE PLAZA DR SUITE 100
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City | NAPLES
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State | FL
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Zip | 34119-7961
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Country | US
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Telephone | 239-593-6488
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Fax | 239-593-0549
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. SERGEI TALALENKO
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Credential |
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Telephone | 239-593-6488
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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 | DN16081
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License Number State | FL
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