Individual
DR. KENNETH A MERTZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1722 UNIVERSITY BLVD., JACKSONVILLE, FL 32216
(904) 253-1240
(904) 727-6548
Mailing address
900 UNIVERSITY BLVD N, MC - 75, JACKSONVILLE, FL 32211-9230
(904) 253-2062
(904) 253-1942
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
DN15901
FL
1223G0001X
General Practice Dentistry
DN15901
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0757179-00
—
FL
05
—
075717900
—
FL
05
—
801488195A
—
GA
Enumeration date
02/27/2006
Last updated
02/26/2013
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