Provider Demographics
NPI:1902520141
Name:FLORIDA DENTAL IMPLANT INSTITUTE INC
Entity Type:Organization
Organization Name:FLORIDA DENTAL IMPLANT INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRABNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-215-9711
Mailing Address - Street 1:700 2ND AVE N STE 202
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5701
Mailing Address - Country:US
Mailing Address - Phone:251-215-9711
Mailing Address - Fax:
Practice Address - Street 1:700 2ND AVE N STE 202
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5701
Practice Address - Country:US
Practice Address - Phone:251-215-9711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental