Provider Demographics
NPI:1871973594
Name:TREEHOUSE DENTAL CARE
Entity type:Organization
Organization Name:TREEHOUSE DENTAL CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ECK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:239-992-4866
Mailing Address - Street 1:8951 BONITA BEACH RD SE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-4201
Mailing Address - Country:US
Mailing Address - Phone:239-992-4866
Mailing Address - Fax:
Practice Address - Street 1:8951 BONITA BEACH RD SE
Practice Address - Street 2:SUITE 220
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-4201
Practice Address - Country:US
Practice Address - Phone:239-992-4866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN153951223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty