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Organization

AMELIA DENTAL GROUP, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LAURIE KITSON DMD (SEC)
(904) 261-7181
Entity
Organization

Contact information

Practice address
1947 CITRONA DRIVE, FERNANDINA BEACH, FL 32034
(904) 261-7181
(904) 261-9797
Mailing address
1947 CITRONA DRIVE, FERNANDINA BEACH, FL 32034
(904) 261-7181
(904) 261-9797

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN15429
FL
122300000X
Dentist
DN17599
FL
122300000X
Dentist
DN20603
FL
122300000X
Dentist
DN21208
FL
122300000X
Dentist
DN3529
FL
1223E0200X
Endodontics
DN11327
FL

Other

Enumeration date
10/17/2006
Last updated
12/21/2015
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