Organization
HIREZI HIREZI DMD PA
Active
Parent organization
HIREZI FAMILY DENTISTRY
Other names
Hirezi Family Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
HIREZI FAMILY DENTISTRY
Authorized official
LOTTIE M DESCALLAR (PRACTICE ADMINISRATOR)
(904) 733-9191
Entity
Organization
Contact information
Practice address
4495 BAYMEADOWS RD, JACKSONVILLE, FL 32217-4716
(904) 733-9191
Mailing address
4495 BAYMEADOWS RD, JACKSONVILLE, FL 32217-4716
(904) 733-9191
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
13089
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639241821
ALL DENTAL INSURANCE
FL
Enumeration date
07/30/2013
Last updated
07/30/2013
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