Provider Demographics
NPI:1043366032
Name:ASPINWALL, GARY ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:ROBERT
Last Name:ASPINWALL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5823 RIVERSIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919
Mailing Address - Country:US
Mailing Address - Phone:239-482-6180
Mailing Address - Fax:
Practice Address - Street 1:16520 S TAMIAMI TRL
Practice Address - Street 2:ST 106
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4569
Practice Address - Country:US
Practice Address - Phone:239-482-2296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11028122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist