South Lake Dental Care | |
2233 County Road 210 West St. Johns FL 32259 | |
(904) 494-8115 | |
Not Available |
Full Name | South Lake Dental Care |
---|---|
Speciality | Dentist - General Practice |
Location | 2233 County Road 210 West, St. Johns, Florida |
Authorized Official Name and Position | Allison Varner (INSURANCE/CREDENTIALING) |
Authorized Official Contact | 2175405100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
South Lake Dental Care 2233 County Road 210 West St. Johns FL 32259 Ph: (904) 494-8115 | South Lake Dental Care 2233 County Road 210 West St. Johns FL 32259 Ph: (904) 494-8115 |
NPI Number | 1174861793 |
---|---|
Provider Enumeration Date | 01/17/2013 |
Last Update Date | 01/17/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174861793 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |