Provider Demographics
NPI:1083236426
Name:SYNE, QAYSIR (DDS)
Entity Type:Individual
Prefix:DR
First Name:QAYSIR
Middle Name:
Last Name:SYNE
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 1:15755 PORTOFINO SPRINGS BLVD APT 103
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-8533
Mailing Address - Country:US
Mailing Address - Phone:239-297-2094
Mailing Address - Fax:
Practice Address - Street 1:15755 PORTOFINO SPRINGS BLVD APT 103
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-8533
Practice Address - Country:US
Practice Address - Phone:239-297-2094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZS15QH122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist