Guided Smiles Prosthodontics & Implant Center Pllc
NPI #1114641339 in Ponte Vedra, Florida
Provider Information
- NPI Number
- 1114641339
- Entity Type
- Organization
- Organization Name
- Guided Smiles Prosthodontics & Implant Center Pllc
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Sep 30, 2022
- Last Updated
- Sep 30, 2022
Practice Location
- Address
- 153 FORT WADE ROAD
- Address 2
- STE 100
- City
- Ponte Vedra
- State
- Florida
- ZIP Code
- 32081
- Phone
- (904) 395-5501
Authorized Official
- Name
- DR. ALONZO CARLOS BLACKMON, DDS
- Title
- AUTHORIZED OFFICIAL
- Phone
- (904) 395-5501
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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