Organization
FIRE CREEK DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA SHELLMAN (MANAGER)
(904) 387-3535
Entity
Organization
Contact information
Practice address
1510 WILLOW BRANCH AVE, JACKSONVILLE, FL 32205-8118
(904) 387-3535
(904) 389-1208
Mailing address
1510 WILLOW BRANCH AVE, JACKSONVILLE, FL 32205-8118
(904) 387-3535
(904) 389-1208
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2333
FL
Other
Enumeration date
01/24/2006
Last updated
08/22/2020
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