Provider Demographics
NPI:1427279827
Name:NAPLES DENTAL ART CENTER, INC.
Entity type:Organization
Organization Name:NAPLES DENTAL ART CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:M
Authorized Official - Last Name:ETESSAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:239-430-0532
Mailing Address - Street 1:4325 TAMIAMI TRL N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-3106
Mailing Address - Country:US
Mailing Address - Phone:239-430-0532
Mailing Address - Fax:239-430-0428
Practice Address - Street 1:4325 TAMIAMI TRL N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-3106
Practice Address - Country:US
Practice Address - Phone:239-430-0532
Practice Address - Fax:239-430-0428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty