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General NPI Number Information
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NPI Number | 1801595210
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Entity Type | Organization
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Legal Business Name | BONITA ENDODONTIC ASSOCIATES, PLLC
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Dates
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Enumeration Date | 02/24/2023
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Last Update Date | 02/24/2023
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Provider Practice Location Address
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Address Line | 8899 TIMBERWILDE DR STE 3
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-7896
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Country | US
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Telephone | 239-498-7668
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Fax | 239-498-7630
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Provider Business Mailing Address
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Address Line | 8899 TIMBERWILDE DR STE 3
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-7896
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Country | US
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Telephone | 239-498-7668
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Fax | 239-498-7630
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Authorized Official
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Title or Position | MEMBER
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Name | DR. NATHAN C. DEWSNUP
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Credential | DMD, MS
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Telephone | 239-498-7668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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