Provider Demographics
NPI:1295745420
Name:HERSHELL GENE STEELE DDS PA
Entity type:Organization
Organization Name:HERSHELL GENE STEELE DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HERSHELL
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:239-980-3630
Mailing Address - Street 1:11017 MILL CREEK HWY
Mailing Address - Street 2:SUITE 1003
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913
Mailing Address - Country:US
Mailing Address - Phone:239-980-3630
Mailing Address - Fax:239-561-6390
Practice Address - Street 1:5781 LEE BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971
Practice Address - Country:US
Practice Address - Phone:239-334-0037
Practice Address - Fax:239-332-4169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15936122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty