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Organization
BEACHWALK DENTAL, PA
Active
Organization
BEACHWALK DENTAL, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA NARDUCCI (GENERAL COUNSEL)
(904) 626-6023
Entity
Organization
Contact information
Practice address
855 COUNTY ROAD 210 WEST, SUITE A2 AND A3, ST. AUGUSTINE, FL 32259
(904) 549-9045
Mailing address
2801 SAINT JOHNS BLUFF RD S STE 101, JACKSONVILLE, FL 32246-3862
(904) 998-7000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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