| Rennigade Dental Group Pllc | |
|
1747 Us Highway 1 S St Augustine FL 32084-4238 | |
| (904) 495-0881 | |
| Not Available |
| Full Name | Rennigade Dental Group Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1747 Us Highway 1 S, St Augustine, Florida |
| Authorized Official Name and Position | Kevon Rennie (OWNER) |
| Authorized Official Contact | 9044950881 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rennigade Dental Group Pllc Po Box 70887 Cleveland OH 44190-0887 Ph: () - | Rennigade Dental Group Pllc 1747 Us Highway 1 S St Augustine FL 32084-4238 Ph: (904) 495-0881 |
| NPI Number | 1316600356 |
|---|---|
| Provider Enumeration Date | 10/18/2021 |
| Last Update Date | 06/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316600356 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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