Provider Demographics
NPI:1215129275
Name:DENTAL ASSOCIATES OF CAPE CORAL, PA
Entity type:Organization
Organization Name:DENTAL ASSOCIATES OF CAPE CORAL, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-274-2499
Mailing Address - Street 1:1715 CAPE CORAL PKWY W
Mailing Address - Street 2:SUITE #11
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-6914
Mailing Address - Country:US
Mailing Address - Phone:239-542-3185
Mailing Address - Fax:239-540-3883
Practice Address - Street 1:1715 CAPE CORAL PKWY W
Practice Address - Street 2:SUITE #11
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-6914
Practice Address - Country:US
Practice Address - Phone:239-542-3185
Practice Address - Fax:239-540-3883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty