Provider Demographics
NPI:1184406076
Name:NAPLES GENERAL DENTISTRY LLC
Entity type:Organization
Organization Name:NAPLES GENERAL DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:FREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-845-9695
Mailing Address - Street 1:5100 TAMIAMI TRL N STE 201
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-2810
Mailing Address - Country:US
Mailing Address - Phone:239-384-9566
Mailing Address - Fax:
Practice Address - Street 1:5100 TAMIAMI TRL N STE 201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-2810
Practice Address - Country:US
Practice Address - Phone:239-384-9566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental