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General NPI Number Information
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NPI Number | 1427279827
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Entity Type | Organization
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Legal Business Name | NAPLES DENTAL ART CENTER, INC.
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4325 TAMIAMI TRL N
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City | NAPLES
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State | FL
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Zip | 34103-3106
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Country | US
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Telephone | 239-430-0532
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Fax | 239-430-0428
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Provider Business Mailing Address
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Address Line | 4325 TAMIAMI TRL N
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City | NAPLES
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State | FL
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Zip | 34103-3106
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Country | US
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Telephone | 239-430-0532
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Fax | 239-430-0428
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ALI M ETESSAM
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Credential | D.D.S.
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Telephone | 239-430-0532
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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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