| Palm Leaf Dental | |
|
100 Marketside Ave Ste 306 Ponte Vedra FL 32081-0582 | |
| (904) 810-5702 | |
| Not Available |
| Full Name | Palm Leaf Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 100 Marketside Ave Ste 306, Ponte Vedra, Florida |
| Authorized Official Name and Position | Aaron Evens (OWNER) |
| Authorized Official Contact | 9048105702 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Palm Leaf Dental 100 Marketside Avenue, Ste 306 Ponte Vedra FL 32081 Ph: (904) 810-5702 | Palm Leaf Dental 100 Marketside Ave Ste 306 Ponte Vedra FL 32081-0582 Ph: (904) 810-5702 |
| NPI Number | 1609293034 |
|---|---|
| Provider Enumeration Date | 03/24/2014 |
| Last Update Date | 03/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609293034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN18137 (Florida) | Primary |
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