Provider Demographics
NPI:1407372824
Name:SKATES, ERIK MATTHEW (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:MATTHEW
Last Name:SKATES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4785 SKATES CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-7336
Mailing Address - Country:US
Mailing Address - Phone:352-219-5713
Mailing Address - Fax:239-694-7697
Practice Address - Street 1:10551 6 MILE CYPRESS PKWY
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-6461
Practice Address - Country:US
Practice Address - Phone:239-694-5700
Practice Address - Fax:239-694-0426
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN2301231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice