| Amelia Island Periodontics | |
|
1361 13th Ave S Ste 220 Jacksonville Beach FL 32250-3236 | |
| (904) 273-4373 | |
| (904) 242-8747 |
| Full Name | Amelia Island Periodontics |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1361 13th Ave S Ste 220, Jacksonville Beach, Florida |
| Authorized Official Name and Position | Michelle E Hougland (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 9042734373 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amelia Island Periodontics 1361 13th Ave S Ste 220 Jacksonville Beach FL 32250-3236 Ph: (904) 273-4373 | Amelia Island Periodontics 1361 13th Ave S Ste 220 Jacksonville Beach FL 32250-3236 Ph: (904) 273-4373 |
| NPI Number | 1841698883 |
|---|---|
| Provider Enumeration Date | 12/08/2014 |
| Last Update Date | 01/07/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841698883 | NPI | - | NPPES |
| 1801982145 | Other | FL | DENTIST, PERIODONTITIS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | DN14294 (Florida) | Primary |
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