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General NPI Number Information
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NPI Number | 1427520360
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Entity Type | Individual
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Provider Name | JAMES MICHAEL D'AMICO D.D.S., M.S.
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Gender | Male
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Dates
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Enumeration Date | 12/17/2018
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Last Update Date | 12/17/2018
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Provider Practice Location Address
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Address Line | 3700 CENTRAL AVE
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City | FORT MYERS
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State | FL
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Zip | 33901-7649
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Country | US
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Telephone | 239-939-5233
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Fax |
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Provider Business Mailing Address
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Address Line | 4325 GARDEN BLVD
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City | CAPE CORAL
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State | FL
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Zip | 33909-3281
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Country | US
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Telephone | 239-204-7984
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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 | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 032846
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License Number State | NY
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