Organization
LAFAYETTE COUNTY HEALTH DEPARTMENT-DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA KIM PEPPER (BUSINESS MANAGER)
(386) 362-2708
Entity
Organization
Contact information
Practice address
140 SW VIRGINIA CIR, MAYO, FL 32066-4064
(386) 294-2012
(386) 294-3457
Mailing address
PO BOX 1806, MAYO, FL 32066-1806
(386) 294-1321
(386) 294-3457
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
DN 14318
FL
Other
Enumeration date
08/04/2006
Last updated
08/22/2020
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