| First Coast Dental Group, Pa | |
|
802 3rd St Neptune Beach FL 32266-5018 | |
| (904) 247-0111 | |
| Not Available |
| Full Name | First Coast Dental Group, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 802 3rd St, Neptune Beach, Florida |
| Authorized Official Name and Position | Anthony Ramiro Corral (CEO) |
| Authorized Official Contact | 9042470111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| First Coast Dental Group, Pa 802 3rd St Neptune Beach FL 32266-5018 Ph: (904) 247-0111 | First Coast Dental Group, Pa 802 3rd St Neptune Beach FL 32266-5018 Ph: (904) 247-0111 |
| NPI Number | 1336495274 |
|---|---|
| Provider Enumeration Date | 07/30/2012 |
| Last Update Date | 07/30/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336495274 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN17063 (Florida) | Primary |
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