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General NPI Number Information
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NPI Number | 1952540270
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Entity Type | Organization
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Legal Business Name | DENTAL DESIGNS OF FORT MYERS, LLC
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Dates
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Enumeration Date | 02/10/2009
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Last Update Date | 04/26/2018
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Provider Practice Location Address
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Address Line | 3230 FORUM BLVD STE 501
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City | FORT MYERS
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State | FL
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Zip | 33905-5580
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Country | US
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Telephone | 239-628-1300
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Fax | 239-262-7970
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Provider Business Mailing Address
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Address Line | 3230 FORUM BLVD STE 501
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City | FORT MYERS
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State | FL
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Zip | 33905-5580
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Country | US
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Telephone | 239-628-1300
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Fax | 239-262-7970
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Authorized Official
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Title or Position | OWNER/MGR
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Name | DR. RAMON PADILLA
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Credential | DDS
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Telephone | 239-628-1300
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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 | 16414
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License Number State | FL
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