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Organization
MOBILE DENTAL HEAD- START LLC
Active
Organization
MOBILE DENTAL HEAD- START LLC
Active
Other names
MOBILE DENTAL HEAD - START LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KENJULA BROWN (OWNER)
(904) 300-0126
Entity
Organization
Contact information
Practice address
1839 LANE AVE S STE 104, JACKSONVILLE, FL 32210-1260
(904) 300-0126
Mailing address
1839 LANE AVE S STE 104, JACKSONVILLE, FL 32210-1260
(904) 300-0126
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/15/2024
Last updated
10/24/2024
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