# DR. ROBERT R. THOUSAND III P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124265640
- **Authorized official:** DR. ROBERT R THOUSAND III D.D.S. (OWNER)
- **Authorized official phone:** (904) 797-3044

## Contact information

- **Practice address:** 10 SAINT JOHNS MEDICAL PK DR, SUITE C, ST AUGUSTINE, FL 32086-5202
- **Practice address phone:** (904) 797-3044
- **Practice address fax:** (904) 797-3045
- **Mailing address:** 10 SAINT JOHNS MEDICAL PK DR, SUITE C, ST AUGUSTINE, FL 32086-5202
- **Mailing address phone:** (904) 797-3044
- **Mailing address fax:** (904) 797-3045

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | DN 14671 | FL | Yes |

## Other

- **Enumeration date:** 01/21/2009
- **Last updated:** 01/21/2009