MEDICARE: DR. THOMAS EDWARD ALBERT JR. D.M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DN14518	FL

General Provider Information

NPI Number	:	1063639508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS EDWARD ALBERT JR. D.M.D

Provider Business Mailing Address
First Line	:	5641 NAPLES BLVD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34109-2023
Country	:	US
Telephone Number	:	230-592-6300
Fax Number	:	239-592-6597

Provider Business Practice Location Address
First Line	:	5641 NAPLES BLVD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34109-2023
Country	:	US
Telephone Number	:	230-592-6300
Fax Number	:	239-592-6597

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	07/17/2007

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