| Aspen Dental | |
|
1747 Us Highway 1 S Saint Augustine FL 32084-4238 | |
| (904) 495-0881 | |
| (904) 824-9257 |
| Full Name | Aspen Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1747 Us Highway 1 S, Saint Augustine, Florida |
| Authorized Official Name and Position | Kevon E Rennie (OWNER) |
| Authorized Official Contact | 9044950881 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspen Dental Po Box 3189 Syracuse NY 13220-3189 Ph: (315) 454-6000 | Aspen Dental 1747 Us Highway 1 S Saint Augustine FL 32084-4238 Ph: (904) 495-0881 |
| NPI Number | 1649633470 |
|---|---|
| Provider Enumeration Date | 03/30/2016 |
| Last Update Date | 03/30/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649633470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN21399 (Florida) | Primary |
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