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General NPI Number Information
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NPI Number | 1568566818
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Entity Type | Individual
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Provider Name | WALTER K BICKNESE DDS
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Gender | Male
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1105 SE 47TH TERRACE
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City | CAPE CORAL
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State | FL
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Zip | 33904
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Country | US
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Telephone | 239-542-4626
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Fax | 239-542-1323
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Provider Business Mailing Address
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Address Line | 413 SE 42ND TERRACE
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City | CAPE CORAL
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State | FL
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Zip | 33904
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Country | US
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Telephone | 239-542-7432
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9979
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License Number State | NY
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