| NPI | 1437479169 |
|---|---|
| Doing Business As | MAIN STREET CHILDREN'S DENTISTRY OF FT. MYERS |
| Entity Type | Organization |
| Authorized Contact | MELVYN GOBER CEO 305-274-2499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2012-07-10 |