Provider Demographics
NPI:1053783209
Name:NORTH CAPE DENTAL ASSOCIATES
Entity type:Organization
Organization Name:NORTH CAPE DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ADAMS
Authorized Official - Last Name:GREIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:239-222-2919
Mailing Address - Street 1:2481 DEL PRADO BLVD NORTH
Mailing Address - Street 2:SUITE 114
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-4475
Mailing Address - Country:US
Mailing Address - Phone:239-945-0012
Mailing Address - Fax:
Practice Address - Street 1:5523 SEVILLE RD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-1014
Practice Address - Country:US
Practice Address - Phone:239-222-2919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8703261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental