Organization
STEPHANIE KINSEY DDS
Active
Other names
Palencia Dental
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE KINSEY DDS (OWNER)
(904) 826-4343
Entity
Organization
Contact information
Practice address
159 PALENCIA VILLAGE DR STE 107-109, ST AUGUSTINE, FL 32095-8457
(904) 826-4343
Mailing address
159 PALENCIA VILLAGE DR STE 107-109, ST AUGUSTINE, FL 32095-8457
(904) 826-4343
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
06/20/2019
Last updated
06/20/2019
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