Organization
EMERALD COAST PERIODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN M WOOLSEY DDS (PERIODONTIST)
(850) 678-6485
Entity
Organization
Contact information
Practice address
719 BAYSHORE DRIVE, NICEVILLE, FL 32578
(850) 678-6485
Mailing address
719 BAYSHORE DRIVE, NICEVILLE, FL 32578
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN21004
FL
Other
Enumeration date
05/04/2015
Last updated
05/04/2015
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