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General NPI Number Information
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NPI Number | 1912790411
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Entity Type | Individual
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Provider Name | LAURA BETANCUR DMD
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Gender | Female
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 8016 SUMMERLIN LAKES DR
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City | FORT MYERS
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State | FL
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Zip | 33907-1817
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Country | US
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Telephone | 239-482-2722
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Fax |
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Provider Business Mailing Address
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Address Line | 10770 NW 26TH PL
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City | SUNRISE
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State | FL
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Zip | 33322-1006
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Country | US
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Telephone | 954-701-7095
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 30266
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License Number State | FL
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