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Organization
TALLAHASSEE DENTAL ASSOCIATES, PLLC
Active
Organization
TALLAHASSEE DENTAL ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OTIS GLENN BECK, JR JR. D.M.D. (OWNER)
(850) 656-2636
Entity
Organization
Contact information
Practice address
2929B CAPITAL MEDICAL BLVD, TALLAHASSEE, FL 32308-4407
(850) 656-2636
(850) 656-0220
Mailing address
2929B CAPITAL MEDICAL BLVD, TALLAHASSEE, FL 32308-4407
(850) 656-2636
(850) 656-0220
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8116
FL
1223G0001X
General Practice Dentistry
9826
FL
Other
Enumeration date
09/11/2008
Last updated
07/13/2017
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