Individual
TRACY MONTOYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
200 SAN SEBASTIAN VW, ST AUGUSTINE, FL 32084-8695
(904) 209-3250
Mailing address
2228 BROAD WATER CT, JACKSONVILLE, FL 32225-4337
(516) 643-6056
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH23696
FL
Other
Enumeration date
11/06/2018
Last updated
11/06/2018
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