Luis Fonseca

NPI #1114330586 in Bonita Springs, Florida

Provider Information

NPI Number: 1114330586
Entity Type: Individual
Name: Luis Fonseca
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 3, 2014
Last Updated: Apr 24, 2018

Practice Location

Address: 28441 S TAMIAMI TRL
City: Bonita Springs
State: Florida
ZIP Code: 34134-3212
Phone: (239) 316-9044

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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