Southside Dermatology, P.a.

NPI #1023276607 in Jacksonville, Florida

Provider Information

NPI Number: 1023276607
Entity Type: Organization
Organization Name: Southside Dermatology, P.a.
Primary Specialty: Specialist
Enumeration Date: May 29, 2008
Last Updated: Jul 2, 2014

Practice Location

Address: 4727 SUNBEAM RD
Address 2: SUITE 101
City: Jacksonville
State: Florida
ZIP Code: 32257-6107
Phone: (904) 880-0622

Authorized Official

Name: DR. MARY TRINH PENTEL, M.D.
Title: PRESIDENT
Phone: (904) 880-0622

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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