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Organization
PINECREST DENTISTRY, PC
Active
Organization
PINECREST DENTISTRY, PC
Active
Other names
Pinecrest Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN BRIDWELL (CREDENTIALING ADMIN)
(714) 845-8231
Entity
Organization
Contact information
Practice address
13623 S DIXIE HWY, SUITE 147, PALMETTO BAY, FL 33176-7295
(305) 330-9882
Mailing address
17000 RED HILL AVE, IRVINE, CA 92614-5626
(714) 845-8500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/20/2017
Last updated
02/20/2017
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