| Islands Edge Dental, Llc | |
|
1301 Plantation Island Dr S Ste 104b St Augustine FL 32080-3110 | |
| (904) 461-5566 | |
| (904) 461-0084 |
| Full Name | Islands Edge Dental, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1301 Plantation Island Dr S Ste 104b, St Augustine, Florida |
| Authorized Official Name and Position | Andrew Mullet (GENERAL DENTIST) |
| Authorized Official Contact | 9044615566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Islands Edge Dental, Llc 1301 Plantation Island Dr S Ste 104b St Augustine FL 32080-3110 Ph: (904) 461-5566 | Islands Edge Dental, Llc 1301 Plantation Island Dr S Ste 104b St Augustine FL 32080-3110 Ph: (904) 461-5566 |
| NPI Number | 1861162141 |
|---|---|
| Provider Enumeration Date | 09/17/2021 |
| Last Update Date | 09/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861162141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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