| Eccella Smiles Pa | |
|
1400 Marsh Landing Pkwy Suite 104 Jacksonville Beach FL 32250-2493 | |
| (904) 834-3737 | |
| Not Available |
| Full Name | Eccella Smiles Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1400 Marsh Landing Pkwy, Jacksonville Beach, Florida |
| Authorized Official Name and Position | William Scott Wagner (OWNER) |
| Authorized Official Contact | 9048343737 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eccella Smiles Pa 1400 Marsh Landing Pkwy Suite 104 Jacksonville Beach FL 32250-2493 Ph: (904) 834-3737 | Eccella Smiles Pa 1400 Marsh Landing Pkwy Suite 104 Jacksonville Beach FL 32250-2493 Ph: (904) 834-3737 |
| NPI Number | 1568852010 |
|---|---|
| Provider Enumeration Date | 02/04/2015 |
| Last Update Date | 02/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568852010 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN14961 (Florida) | Primary |
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