Organization · Type 2 NPI
Jacksonville Family Dentistry at Southside, Inc
Dental Clinic/Center · Jacksonville, FL
NPI number
1073024006
Active
Practice location
8101 Southside Blvd Ste 8
Jacksonville, FL 32256-8005
Mailing address
100 Fairway Park Blvd Unit 512
Ponte Vedra Beach, FL 32082-2667
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | 16941 (FL) |
Dental Clinic/Center: Definition to come...
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About NPI 1073024006
Jacksonville Family Dentistry at Southside, Inc's National Provider Identifier is 1073024006, issued on Oct 17, 2017. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Jacksonville, FL. The record was last updated on Oct 17, 2017.