Organization
ADVANCED DENTAL CARE OF JACKSONVILLE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE COLE (INSURANCE DIRECTOR)
(727) 726-1611
Entity
Organization
Contact information
Practice address
4540 SOUTHSIDE BLVD, 1001, JACKSONVILLE, FL 32216-5492
(904) 725-4433
Mailing address
4540 SOUTHSIDE BLVD, 1001, JACKSONVILLE, FL 32216-5492
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/15/2007
Last updated
05/17/2010
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