Edison Mall Dental PA
Edison Mall Dental PA is a Dentist in Fort Myers, Florida. Licensed in Florida. Registered with an NPI since 2014.
- Licensed in
- FL
- In the registry since
- 2014
What do these letters mean?
- PA — Professional association
- A form of business registration, not a clinical qualification.
Practice location Address checks out
4125 Cleveland Ave Ste 1430Fort Myers, FL 33901-9046
Phone: (954) 846-7171
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dentist (primary) | Taxonomy 122300000X · Licence DN16377 (FL) |
|---|
Record details
| NPI number | 1831500404 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Rostislav Krasnov — Dds · (954) 846-7171 |
| NPI enumerated | May 16, 2014 |
| Last updated in NPPES | May 16, 2014 |
| Mailing address | 4125 Cleveland Ave, Suite 1430, Fort Myers, FL 33901-9046 |
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