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General NPI Number Information
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NPI Number | 1871973594
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Entity Type | Organization
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Legal Business Name | TREEHOUSE DENTAL CARE
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Dates
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Enumeration Date | 06/08/2015
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Last Update Date | 06/08/2015
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Provider Practice Location Address
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Address Line | 8951 BONITA BEACH RD SE SUITE 220
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4201
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Country | US
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Telephone | 239-992-4866
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Fax |
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Provider Business Mailing Address
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Address Line | 8951 BONITA BEACH RD SE SUITE 220
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4201
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Country | US
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Telephone | 239-992-4866
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FREDERICK ECK
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Credential | DDS
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Telephone | 239-992-4866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN15395
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License Number State | FL
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