# JC FAMILY DENTISTRY PA

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

## Provider details

- **NPI number:** 1518464866
- **Authorized official:** JONATHAN COHEN (PRESIDENT)
- **Authorized official phone:** (904) 230-2961

## Contact information

- **Practice address:** 485 STATE ROAD 13 STE 4, SAINT JOHNS, FL 32259-2993
- **Practice address phone:** (904) 230-2961
- **Mailing address:** 485 STATE ROAD 13 STE 4, SAINT JOHNS, FL 32259-2993
- **Mailing address phone:** (904) 230-2961

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 04/11/2018
- **Last updated:** 04/11/2018