Organization
ADVANCED DENTAL CARE (JACKSONVILLE SOUTH), PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE GOMEZ (CREDENTIALING COORDINATOR)
(305) 274-2499
Entity
Organization
Contact information
Practice address
3667 CROWN POINT RD, JACKSONVILLE, FL 32257-5956
(305) 274-2499
Mailing address
13195 SW 134TH ST, MIAMI, FL 33186-4461
(305) 274-2499
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/11/2016
Last updated
06/11/2016
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