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Individual

AISHA BA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5455 SPRINGFIELD BLVD, JACKSONVILLE, FL 32208-5166
(904) 394-4963
Mailing address
5455 SPRINGFIELD BLVD, JACKSONVILLE, FL 32208-5166

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0000011760
TN

Other

Enumeration date
02/03/2021
Last updated
07/30/2025
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