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General NPI Number Information
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NPI Number | 1841492956
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Entity Type | Organization
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Legal Business Name | CARA OVERBECK DDS PA
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 08/06/2008
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Provider Practice Location Address
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Address Line | 900 PINE ST SUITE 121
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City | ENGLEWOOD
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State | FL
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Zip | 34223-4418
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Country | US
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Telephone | 941-475-0843
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Fax | 941-488-8788
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Provider Business Mailing Address
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Address Line | 1040 E VENICE AVE
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City | VENICE
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State | FL
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Zip | 34285-7162
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Country | US
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Telephone | 941-488-8788
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Fax | 941-488-5788
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CARA OVERBECK
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Credential | D.D.S.
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Telephone | 941-488-8788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN 10080
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License Number State | FL
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