Organization · Type 2 NPI
Ponce de Leon Family Dentistry
Dental Clinic/Center · St. Augustine, FL
NPI number
1801059480
Active
Practice location
4 Saint Johns Medical Pk Dr
St. Augustine, FL 32086-5298
Fax (904) 797-9057
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
Another provider at this address
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About NPI 1801059480
Ponce de Leon Family Dentistry's National Provider Identifier is 1801059480, issued on Jul 3, 2008. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in St. Augustine, FL. The record was last updated on Jul 3, 2008.