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Organization
TUSCAWILLA DENTAL LLC
Active
Organization
TUSCAWILLA DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID RICHARD MCCREARY DMD (OWNER)
(386) 423-3652
Entity
Organization
Contact information
Practice address
2102 S RIDGEWOOD AVE, STE 6, EDGEWATER, FL 32141-4240
(386) 423-3652
(386) 423-3653
Mailing address
2102 S RIDGEWOOD AVE, STE 6, EDGEWATER, FL 32141-4240
(386) 423-3652
(386) 423-3653
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN15207
FL
Other
Enumeration date
04/29/2008
Last updated
04/29/2008
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