Provider First Line Business Practice Location Address:
14731 N. CLEVELAND AVE.
Provider Second Line Business Practice Location Address:
SUITE 1 COMMUNITY DENTAL CARE
Provider Business Practice Location Address City Name:
N. FORT MYERS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-995-2257
Provider Business Practice Location Address Fax Number:
239-995-4388
Provider Enumeration Date:
03/16/2007