Organization
ATLANTIC DENTISTRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA BASTOS (OFFICE MANAGER)
(904) 647-1800
Entity
Organization
Contact information
Practice address
13474 ATLANTIC BLVD STE 109, JACKSONVILLE, FL 32225-0100
(904) 647-1800
(904) 647-1802
Mailing address
13474 ATLANTIC BLVD STE 109, JACKSONVILLE, FL 32225-0100
(904) 647-1800
(904) 647-1802
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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