| Boulder Rock Dental, Llc | |
|
5 Boulder Rock Dr Ste A Palm Coast FL 32137-8538 | |
| (386) 931-1685 | |
| Not Available |
| Full Name | Boulder Rock Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5 Boulder Rock Dr Ste A, Palm Coast, Florida |
| Authorized Official Name and Position | Tanya Whitaker (OFFICE MANAGER) |
| Authorized Official Contact | 3862769051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boulder Rock Dental, Llc 5 Boulder Rock Dr Ste A Palm Coast FL 32137-8538 Ph: (386) 276-9051 | Boulder Rock Dental, Llc 5 Boulder Rock Dr Ste A Palm Coast FL 32137-8538 Ph: (386) 931-1685 |
| NPI Number | 1922515204 |
|---|---|
| Provider Enumeration Date | 01/08/2018 |
| Last Update Date | 06/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922515204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN15016 (Florida) | Primary |
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