Coast Dental P.a.

NPI #1770159071 in Bonita Springs, Florida

Provider Information

NPI Number: 1770159071
Entity Type: Organization
Organization Name: Coast Dental P.a.
Subpart: Yes (part of a larger organization)
Parent Organization: COAST DENTAL P.A.
Primary Specialty: Dentist
Enumeration Date: May 28, 2021
Last Updated: May 28, 2021

Practice Location

Address: 26831 S TAMIAMI TRL UNIT 48
City: Bonita Springs
State: Florida
ZIP Code: 34134-7828
Phone: (239) 948-3200

Authorized Official

Name: MELODY RIVERA
Title: CREDENTIALING MANAGER
Phone: (813) 350-7166

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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