| Mclellan Dental Inc. | |
|
1100 S Ponce De Leon Blvd Ste 2 St Augustine FL 32084-6013 | |
| (904) 829-6321 | |
| (904) 829-2338 |
| Full Name | Mclellan Dental Inc. |
|---|---|
| Speciality | Dentist |
| Location | 1100 S Ponce De Leon Blvd Ste 2, St Augustine, Florida |
| Authorized Official Name and Position | Matthew Mclellan (OWNER) |
| Authorized Official Contact | 9048296321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mclellan Dental Inc. 1100 S Ponce De Leon Blvd Ste 2 St Augustine FL 32084-6013 Ph: (904) 829-6321 | Mclellan Dental Inc. 1100 S Ponce De Leon Blvd Ste 2 St Augustine FL 32084-6013 Ph: (904) 829-6321 |
| NPI Number | 1790920544 |
|---|---|
| Provider Enumeration Date | 12/09/2008 |
| Last Update Date | 12/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790920544 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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