Boulder Rock Dental, LLC
NPI #1922515204 in Palm Coast, Florida
Provider Information
- NPI Number
- 1922515204
- Entity Type
- Organization
- Organization Name
- Boulder Rock Dental, LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jan 8, 2018
- Last Updated
- Jun 12, 2024
Practice Location
- Address
- 5 BOULDER ROCK DR STE A
- City
- Palm Coast
- State
- Florida
- ZIP Code
- 32137-8538
- Phone
- (386) 931-1685
Authorized Official
- Name
- TANYA WHITAKER
- Title
- OFFICE MANAGER
- Phone
- (386) 276-9051
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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