South Jacksonville Dental Pllc
NPI #1003287814 in Jacksonville, Florida
Provider Information
- NPI Number
- 1003287814
- Entity Type
- Organization
- Organization Name
- South Jacksonville Dental Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Oct 20, 2015
- Last Updated
- Oct 20, 2015
Practice Location
- Address
- 8440 BLANDING BLVD
- City
- Jacksonville
- State
- Florida
- ZIP Code
- 32244
- Phone
- (904) 525-8041
Authorized Official
- Name
- KIM VAN CAMP
- Title
- PROVIDER RELATIONS SPECIALIST
- Phone
- (315) 454-6000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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