Benjamin N. Diller, Dds, Pa | |
1200 S 14th St Fernandina Beach FL 32034-3043 | |
(904) 261-0851 | |
(904) 261-5002 |
Full Name | Benjamin N. Diller, Dds, Pa |
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Speciality | Clinic/center - Dental |
Location | 1200 S 14th St, Fernandina Beach, Florida |
Authorized Official Name and Position | Benjamin N Diller (PRESIDENT) |
Authorized Official Contact | 4195096865 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Benjamin N. Diller, Dds, Pa 1200 S 14th St Fernandina Beach FL 32034-3043 Ph: (904) 261-0851 | Benjamin N. Diller, Dds, Pa 1200 S 14th St Fernandina Beach FL 32034-3043 Ph: (904) 261-0851 |
NPI Number | 1811380983 |
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Provider Enumeration Date | 03/12/2015 |
Last Update Date | 03/12/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811380983 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | DN21074 (Florida) | Primary |
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