| Mill Creek Dental Care | |
|
149 Tuscan Way St. Augustine FL 32092-1860 | |
| (904) 201-3205 | |
| Not Available |
| Full Name | Mill Creek Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 149 Tuscan Way, St. Augustine, Florida |
| Authorized Official Name and Position | Allison Varner (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175406077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mill Creek Dental Care 149 Tuscan Way St. Augustine FL 32092-1860 Ph: (904) 201-3205 | Mill Creek Dental Care 149 Tuscan Way St. Augustine FL 32092-1860 Ph: (904) 201-3205 |
| NPI Number | 1609285089 |
|---|---|
| Provider Enumeration Date | 08/11/2014 |
| Last Update Date | 08/11/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609285089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN19379 (Florida) | Primary |
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