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General NPI Number Information
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NPI Number | 1346912565
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Entity Type | Organization
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Legal Business Name | PHILLIP KRAVER DMD, PLLC
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Dates
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Enumeration Date | 10/05/2021
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 3001 DEL PRADO BLVD. S.
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City | CAPE CORAL
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State | FL
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Zip | 33904-7208
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Country | US
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Telephone | 239-549-8921
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Fax | 239-542-2811
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Provider Business Mailing Address
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Address Line | 3001 DEL PRADO BLVD. S.
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City | CAPE CORAL
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State | FL
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Zip | 33904-7208
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Country | US
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Telephone | 239-549-8921
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Fax | 239-542-2811
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Authorized Official
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Title or Position | DENTIST / OWNER
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Name | PHILLIP BRIAN KRAVER
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Credential | DMD
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Telephone | 239-549-8921
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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 |
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License Number State |
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