Edison Mall Dental P.A

LBN: Edison Mall Dental P.A
Edison Mall Dental P.A is an health care organization with primary practice located at 4125 Cleveland Ave Suite 1430, Fort Myers FL 33901-9046. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Edison Mall Dental P.A can be contacted via phone (954) 846-7171, or through Krasnov, Rostislav via phone (954) 846-7171.

Contact Information

Primary practice address
4125 Cleveland Ave Suite 1430 Fort Myers FL 33901-9046
Phone: (954) 846-7171
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Krasnov, Rostislav DENTIST
Phone: (954) 846-7171

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X DN16377 Florida

Profile Details

NPI number 1831500404
LBN Legal business name Edison Mall Dental P.A
DBA Doing business as
Authorized official Krasnov, Rostislav DENTIST
Entity Organization
Organization subpart 1 No
Enumeration date May 16th, 2014
Last updated May 16th, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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