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Organization
CRYSTAL CLEAR DENTAL SPA LLC
Active
Organization
CRYSTAL CLEAR DENTAL SPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIANGIAN HU (OWNER)
(904) 731-2162
Entity
Organization
Contact information
Practice address
7933 BAYMEADOWS WAY STE 5, JACKSONVILLE, FL 32256-7514
(904) 731-2162
Mailing address
7933 BAYMEADOWS WAY STE 5, JACKSONVILLE, FL 32256-7514
(904) 731-2162
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
NULL
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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