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Organization
BEAN SPROUT INC
Active
Organization
BEAN SPROUT INC
Active
Other names
Bean Tree Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JODI MASON DMD (PEDIATRIC DENTIST)
(904) 372-3260
Entity
Organization
Contact information
Practice address
2008 RIVERSIDE AVE, SUITE 101, JACKSONVILLE, FL 32204-4443
(904) 372-3260
(904) 385-3704
Mailing address
2008 RIVERSIDE AVE, SUITE 101, JACKSONVILLE, FL 32204-4443
(904) 372-3260
(904) 385-3704
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
17658
FL
Other
Enumeration date
01/08/2015
Last updated
01/08/2015
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