Organization
FORST PARK DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN M STEWART (OFFICE MANAGER)
(334) 281-2451
Entity
Organization
Contact information
Practice address
2620 JENKS AVE, PANAMA CITY, FL 32405-4311
(850) 785-8586
(334) 281-1087
Mailing address
2620 JENKS AVE, PANAMA CITY, FL 32405-4311
(850) 785-8586
(334) 281-1087
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN 21936
FL
Other
Enumeration date
07/13/2016
Last updated
07/13/2016
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