Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DN20045 | FL |
NPI | 1396186649 |
---|---|
Provider Name | Dr. Ronald Edward Trapp |
First Address | Fort Myers, FL 33905-7320 |
Second Address | Fort Myers, FL 33901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2013 |
Last Update Date | 16/07/2013 |