| Northeast Florida Health Services, Inc. | |
|
1205 S Woodland Blvd Ste 5 Deland FL 32720-7464 | |
| (386) 888-4911 | |
| (386) 269-9951 |
| Full Name | Northeast Florida Health Services, Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1205 S Woodland Blvd Ste 5, Deland, Florida |
| Authorized Official Name and Position | Laurie Asbury (CEO) |
| Authorized Official Contact | 3862026025 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Florida Health Services, Inc. 1205 S Woodland Blvd Ste 3 Deland FL 32720-7464 Ph: (386) 202-6025 | Northeast Florida Health Services, Inc. 1205 S Woodland Blvd Ste 5 Deland FL 32720-7464 Ph: (386) 888-4911 |
| NPI Number | 1588339741 |
|---|---|
| Provider Enumeration Date | 08/10/2021 |
| Last Update Date | 08/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588339741 | NPI | - | NPPES |
| 687955108 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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Terry C Blanks Jr Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 895 South Dexter Ave, Deland, FL 32720 Phone: 386-738-2002 Fax: 386-738-9523 | |
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