Provider Demographics
NPI:1215135793
Name:DEWSNUP, NATHAN CANNON (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:CANNON
Last Name:DEWSNUP
Suffix:
Gender:M
Credentials:DMD, MS
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8899 TIMBERWILDE DR STE 3
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-7896
Mailing Address - Country:US
Mailing Address - Phone:239-498-7668
Mailing Address - Fax:239-498-7630
Practice Address - Street 1:8899 TIMBERWILDE DR STE 3
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-7896
Practice Address - Country:US
Practice Address - Phone:239-498-7668
Practice Address - Fax:239-498-7630
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN223681223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics