Immokalee Dental P.a.

NPI #1457881922 in Immokalee, Florida

Provider Information

NPI Number: 1457881922
Entity Type: Organization
Organization Name: Immokalee Dental P.a.
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 15, 2017
Last Updated: Jun 15, 2017

Practice Location

Address: 1013 W. MAIN ST.
Address 2: UNIT 6A
City: Immokalee
State: Florida
ZIP Code: 34142
Phone: (239) 657-7007

Authorized Official

Name: MICHAEL D. KANE, D.M.D.
Title: DIR.
Phone: (239) 657-7007

Specialties & Taxonomy Codes

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

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