Harborside Dental Assoc Pca
Dentist, General Practice in Punta Gorda, FL. Organization (NPI-2).
NPI number1891740700
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1891740700
- Entity type
- Organization (NPI-2)
- Legal business name
- Harborside Dental Assoc Pca
- Organization subpart
- No
- Enumeration date
- May 23, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
522 E Marion Ave3rd Floor
Punta Gorda, FL 33950
Phone 941-575-9200
Mailing address
522 E Marion AvePunta Gorda, FL 33950
Phone 941-575-9200
Authorized official
Michelle Walbert Moenning
Dentist
9415759200
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