Organization
FLAGLER DENTAL ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMIAH MAHONEY D.M.D. (TREASURER)
(386) 446-3883
Entity
Organization
Contact information
Practice address
30 OFFICE PARK DR, PALM COAST, FL 32137-3808
(386) 445-9318
Mailing address
30 OFFICE PARK DR, PALM COAST, FL 32137-3808
(386) 445-9318
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN16989
FL
Other
Enumeration date
11/19/2008
Last updated
01/05/2010
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