| Ortho 99 Plus 1 Orange Park Llc | |
|
950 Blanding Blvd Ste 20 Orange Park FL 32065-5911 | |
| (904) 619-7140 | |
| Not Available |
| Full Name | Ortho 99 Plus 1 Orange Park Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 950 Blanding Blvd Ste 20, Orange Park, Florida |
| Authorized Official Name and Position | Justin Mcdaniel (OWNER) |
| Authorized Official Contact | 3524942676 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ortho 99 Plus 1 Orange Park Llc 14536 Plumosa Dr Jacksonville Beach FL 32250-2222 Ph: (352) 494-2676 | Ortho 99 Plus 1 Orange Park Llc 950 Blanding Blvd Ste 20 Orange Park FL 32065-5911 Ph: (904) 619-7140 |
| NPI Number | 1790518421 |
|---|---|
| Provider Enumeration Date | 08/20/2024 |
| Last Update Date | 08/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790518421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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