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General NPI Number Information
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NPI Number | 1609361096
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Entity Type | Organization
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Legal Business Name | MARKUS SHERRY DMD PA
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Dates
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Enumeration Date | 06/27/2018
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Last Update Date | 06/27/2018
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Provider Practice Location Address
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Address Line | 14651 PALM BEACH BLVD STE 101
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City | FORT MYERS
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State | FL
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Zip | 33905-2331
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Country | US
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Telephone | 239-694-9993
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Fax | 239-561-9996
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Provider Business Mailing Address
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Address Line | 25 CARROTWOOD CT
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City | FORT MYERS
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State | FL
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Zip | 33919-7531
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Country | US
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Telephone | 239-229-6255
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Fax | 239-561-9996
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Authorized Official
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Title or Position | OWNER
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Name | MARKUS SHERRY
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Credential | DMD
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Telephone | 239-229-6255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DN8099
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License Number State | FL
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