Professional Dental Alliance of Jacksonville Beach, Pllc
NPI #1366072464 in Jacksonville, Florida
Provider Information
- NPI Number
- 1366072464
- Entity Type
- Organization
- Organization Name
- Professional Dental Alliance of Jacksonville Beach, Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jan 17, 2020
- Last Updated
- Jan 17, 2020
Practice Location
- Address
- 14054 BEACH BLVD STE 10
- City
- Jacksonville
- State
- Florida
- ZIP Code
- 32250-1596
- Phone
- (904) 821-8330
Authorized Official
- Name
- LAUREN HOWARD
- Title
- CREDENTIALING SPECIALIST
- Phone
- (757) 576-5479
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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