Provider Demographics
NPI:1255718987
Name:DENTAL SOLUTIONS FOR SENIORS,LLC
Entity type:Organization
Organization Name:DENTAL SOLUTIONS FOR SENIORS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:AVOLA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:239-261-1909
Mailing Address - Street 1:1172 GOODLETTE RD N
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5430
Mailing Address - Country:US
Mailing Address - Phone:239-261-1909
Mailing Address - Fax:239-263-2167
Practice Address - Street 1:1172 GOODLETTE RD N
Practice Address - Street 2:SUITE 101
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5430
Practice Address - Country:US
Practice Address - Phone:239-261-1909
Practice Address - Fax:239-263-2167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-01
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 8028261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental