Organization
COMFORTABLE CARE DENTA HEALTH PROFESSIONALS, PA
Active
Parent organization
COMFORTABLE CARE DENTA HEALTH PROFESSIONALS, PA
Other names
Lakeside Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMFORTABLE CARE DENTA HEALTH PROFESSIONALS, PA
Authorized official
TABATHA LEMKE (CREDENTIALING COORDINATOR)
(217) 540-6078
Entity
Organization
Contact information
Practice address
2511 SAINT JOHNS BLUFF RD S STE 206, JACKSONVILLE, FL 32246-2345
(904) 329-3371
Mailing address
2511 SAINT JOHNS BLUFF RD S STE 206, JACKSONVILLE, FL 32246-2345
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/21/2020
Last updated
12/21/2020
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