Eccella Smiles PA
NPI #1568852010 in Jacksonville Beach, Florida
Provider Information
- NPI Number
- 1568852010
- Entity Type
- Organization
- Organization Name
- Eccella Smiles PA
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Feb 4, 2015
- Last Updated
- Feb 4, 2015
Practice Location
- Address
- 1400 MARSH LANDING PKWY
- Address 2
- SUITE 104
- State
- Florida
- ZIP Code
- 32250-2493
- Phone
- (904) 834-3737
Authorized Official
- Name
- DR. WILLIAM SCOTT WAGNER, DMD, PA
- Title
- OWNER
- Phone
- (904) 834-3737
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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