| Michael Gagaoudakis | |
|
814 A1a N Suite 102 Ponte Vedra FL 32082-3271 | |
| (904) 686-1576 | |
| (904) 686-1706 |
| Full Name | Michael Gagaoudakis |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 814 A1a N, Ponte Vedra, Florida |
| Authorized Official Name and Position | Michael E Gagaoudakis (PRESIDENT) |
| Authorized Official Contact | 9046861576 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Gagaoudakis 814 A1a N Suite 102 Ponte Vedra FL 32082-3271 Ph: (904) 686-1576 | Michael Gagaoudakis 814 A1a N Suite 102 Ponte Vedra FL 32082-3271 Ph: (904) 686-1576 |
| NPI Number | 1346493376 |
|---|---|
| Provider Enumeration Date | 11/04/2008 |
| Last Update Date | 11/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346493376 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN17757 (Florida) | Primary |
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