| C R Fort Dmd Plc | |
|
330 E Broadway St Fort Meade FL 33841-3012 | |
| (863) 285-7121 | |
| (863) 285-8648 |
| Full Name | C R Fort Dmd Plc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 330 E Broadway St, Fort Meade, Florida |
| Authorized Official Name and Position | Charles Robert Fort (OWNER) |
| Authorized Official Contact | 8632857121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| C R Fort Dmd Plc 330 E Broadway St Fort Meade FL 33841-3012 Ph: (863) 285-7121 | C R Fort Dmd Plc 330 E Broadway St Fort Meade FL 33841-3012 Ph: (863) 285-7121 |
| NPI Number | 1831443258 |
|---|---|
| Provider Enumeration Date | 11/07/2012 |
| Last Update Date | 11/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831443258 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8002 (Florida) | Primary |