| Brushes And Brackets Dental Studio | |
|
2255 Dunn Ave Ste 700 Jacksonville FL 32218-4742 | |
| (904) 751-5126 | |
| (904) 751-5146 |
| Full Name | Brushes And Brackets Dental Studio |
|---|---|
| Speciality | Clinic/Center |
| Location | 2255 Dunn Ave Ste 700, Jacksonville, Florida |
| Authorized Official Name and Position | Tanya Wall (OWNER) |
| Authorized Official Contact | 9047515126 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brushes And Brackets Dental Studio 2255 Dunn Ave Ste 700 Jacksonville FL 32218-4742 Ph: (904) 751-5126 | Brushes And Brackets Dental Studio 2255 Dunn Ave Ste 700 Jacksonville FL 32218-4742 Ph: (904) 751-5126 |
| NPI Number | 1023772704 |
|---|---|
| Provider Enumeration Date | 10/28/2021 |
| Last Update Date | 10/28/2021 |
| Medicare PECOS PAC ID | 0042741944 |
|---|---|
| Medicare Enrollment ID | O20241002003601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023772704 | NPI | - | NPPES |
| 103221100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Tanya C Wall |
|---|---|
| Provider Type | Practitioner - Pediatric Dentistry |
| Provider Identifiers | NPI Number: 1063528586 PECOS PAC ID: 1951832856 Enrollment ID: I20241002003698 |
Donald L. Smitha, Dds, Mds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 812 Alderman Rd, Jacksonville, FL 32211 Phone: 904-725-8282 Fax: 904-725-7197 | |
Selena L Marchan, Dmd, Pa Dental Clinic Medicare: Medicare Enrolled Practice Location: 13475 Atlantic Blvd, Ste 36, Jacksonville, FL 32225 Phone: 904-246-2603 Fax: 904-247-9663 | |
Roger D. Robinson Jr., D.m.d., P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3595 Cardinal Point Drive, Jacksonville, FL 32257 Phone: 904-737-2040 Fax: 904-737-2051 | |
Ben Lewis, D.d.s., P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 425 N Lee St, Jacksonville, FL 32204 Phone: 904-366-3736 | |
Joseph G Chiafair Dds Ms Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9471 Baymeadows Rd, Suite 101, Jacksonville, FL 32256 Phone: 904-739-3939 Fax: 904-739-1381 | |
Timothy J Parker Dmd Pa Dental Clinic Medicare: Medicare Enrolled Practice Location: 8351 Bayberry Rd, Jacksonville, FL 32256 Phone: 904-737-3263 Fax: 904-448-5301 |