Organization
EASY STREET DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER PARKS (SENIOR ACCOUNT SPECIALIST)
(904) 998-7000
Entity
Organization
Contact information
Practice address
2130 SW 22ND PL STE 102, OCALA, FL 34471-7754
(904) 998-7000
Mailing address
2801 SAINT JOHNS BLUFF RD S STE 4, JACKSONVILLE, FL 32246-3743
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/10/2017
Last updated
08/10/2017
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