Organization
MIDTOWN DENTAL OF JACKSONVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL L LESS (VP OF OPERATIONS)
(904) 998-7000
Entity
Organization
Contact information
Practice address
2801 SAINT JOHNS BLUFF RD S, SUITE 1, JACKSONVILLE, FL 32246-3761
(904) 641-3777
(904) 641-2146
Mailing address
3545-1 ST. JOHNS BLUFF RD. S., SUITE 352, JACKSONVILLE, FL 32224
(904) 998-7000
(904) 998-7702
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
FL
Other
Enumeration date
10/23/2006
Last updated
01/26/2015
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