Coastal Periodontics Practice | |
82 Beal Pkwy Sw Fort Walton Beach FL 32548-5331 | |
(850) 862-6666 | |
Not Available |
Full Name | Coastal Periodontics Practice |
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Speciality | Dentist - Periodontics |
Location | 82 Beal Pkwy Sw, Fort Walton Beach, Florida |
Authorized Official Name and Position | Faith Gaskins (DIRECTOR OF CREDENTIALING) |
Authorized Official Contact | 9728693789 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Coastal Periodontics Practice 82 Beal Pkwy Sw Fort Walton Beach FL 32548-5331 Ph: (850) 862-6666 | Coastal Periodontics Practice 82 Beal Pkwy Sw Fort Walton Beach FL 32548-5331 Ph: (850) 862-6666 |
NPI Number | 1205449584 |
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Provider Enumeration Date | 08/26/2020 |
Last Update Date | 08/26/2020 |
Identifier | Type | State | Issuer |
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1205449584 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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