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Organization
PODVIA AND STANFORD DMDS
Active
Organization
PODVIA AND STANFORD DMDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTAN PODVIA DMD (DENTIST)
(904) 765-5573
Entity
Organization
Contact information
Practice address
3118 NEW BERLIN ROAD, SUITE 1, JACKSONVILLE, FL 32226
(904) 765-5573
Mailing address
3118 NEW BERLIN ROAD, SUITE 1, JACKSONVILLE, FL 32226
(904) 765-5573
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN0014583
FL
Other
Enumeration date
09/20/2006
Last updated
05/23/2013
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