904 IMPLANTS AND DENTURES PLLC NPI 1700549136

NPI Information

NPI: 1700549136
Provider Name: 904 IMPLANTS AND DENTURES PLLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
11645 BEACH BLVD STE 101
JACKSONVILLE, FL
ZIP 32246
Phone: (904) 999-9000
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904 IMPLANTS AND DENTURES PLLC is a dental clinic center in Jacksonville, FL. 904 IMPLANTS AND DENTURES PLLC NPI is 1700549136. The provider is registered as an organization entity type.

The provider's business location address is:

11645 BEACH BLVD STE 101
JACKSONVILLE, FL
ZIP 32246-496
Phone: (904) 999-9000

The provider's authorized official is William Russell .
The authorized official title is Co-owner and has the following contact phone number (803) 665-6998.

The enumeration date for this NPI number is 10/21/2021 and was last updated on 10/21/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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