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Organization
JSK FAMILY DENTAL, P.A.
Active
Organization
JSK FAMILY DENTAL, P.A.
Active
Other names
Aspen Dental
Organization subpart
No
Provider details
NPI number
Authorized official
KIM VAN CAMP (PROVIDER RELATIONS SPECIALIST)
(315) 454-6000
Entity
Organization
Contact information
Practice address
7715 GALL BLVD, ZEPHYRHILLS, FL 33541-4315
(813) 782-4200
(813) 782-8523
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(315) 454-6000
(315) 410-5531
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN19816
FL
Other
Enumeration date
05/03/2016
Last updated
05/03/2016
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