Provider Demographics
NPI:1538355029
Name:HARNEY-NASH, ANGELA (DMD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:HARNEY-NASH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ANGLELA
Other - Middle Name:
Other - Last Name:MATRISCIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:7780 CAMBRIDGE MANOR PL
Mailing Address - Street 2:SUITE D
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3656
Mailing Address - Country:US
Mailing Address - Phone:239-275-7722
Mailing Address - Fax:
Practice Address - Street 1:7780 CAMBRIDGE MANOR PL
Practice Address - Street 2:SUITE D
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3656
Practice Address - Country:US
Practice Address - Phone:239-275-7722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 179441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice