Organization
RDC DENTAL PA
Active
Other names
DDS DENTAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFAEL D CEPEDA DDS (PRESIDENT)
(904) 717-9161
Entity
Organization
Contact information
Practice address
305 E UNION ST, JACKSONVILLE, FL 32202-2748
(904) 717-9161
(904) 717-9167
Mailing address
305 E UNION ST, JACKSONVILLE, FL 32202-2748
(904) 717-9161
(904) 717-9167
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN17040
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003095300
—
FL
Enumeration date
04/06/2018
Last updated
04/06/2018
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