Organization
AMANDO DENTAL CORPORATION
Active
Other names
Southside Dental at Tinseltown
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL L LESS (VP OF OPERATIONS)
(904) 998-7000
Entity
Organization
Contact information
Practice address
4540 SOUTHSIDE BLVD, SUITE 801, JACKSONVILLE, FL 32216-5492
(904) 642-2010
(904) 642-8282
Mailing address
3545-1 ST. JOHNS BLUFF RD. S., SUITE 352, JACKSONVILLE, FL 32224
(904) 998-7000
(904) 998-7702
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
DN15716
FL
Other
Enumeration date
06/26/2007
Last updated
01/26/2015
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