Modern Dental Cape Coral Pllc

LBN: Modern Dental Cape Coral Pllc
Modern Dental Cape Coral Pllc is an health care organization with primary practice located at 706 Sw Pine Island Rd Suite 103, Cape Coral FL 33991. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Periodontics. Dental Providers / General Practice is the primary health care specialty. Modern Dental Cape Coral Pllc can be contacted via phone (941) 610-6200, or through Blackenburg, Tyler M via phone (954) 736-7924.

Contact Information

Primary practice address
706 Sw Pine Island Rd Suite 103 Cape Coral FL 33991
Phone: (941) 610-6200
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Blackenburg, Tyler M Doctor of Dental Medicine (DMD)
Phone: (954) 736-7924

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X
Dental Providers / Periodontics 1223P0300X

Profile Details

NPI number 1437785847
LBN Legal business name Modern Dental Cape Coral Pllc
DBA Doing business as
Authorized official Blackenburg, Tyler M Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 Yes
Enumeration date Mar 17th, 2020
Last updated Mar 17th, 2020 - about 4 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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