Organization
ORTHO 99 PLUS 1 BARTRAM PARK LLC
Active
Parent organization
ORTHO 99 PLUS 1
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORTHO 99 PLUS 1
Authorized official
JUSTIN MCDANIEL DMD (OWNER/ORTHODONTIST)
(904) 640-8599
Entity
Organization
Contact information
Practice address
13920 OLD SAINT AUGUSTINE RD STE 103, JACKSONVILLE, FL 32258-5562
(904) 640-8599
Mailing address
7410 MERRILL RD STE 2, JACKSONVILLE, FL 32277-6547
(904) 619-7140
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
11/29/2021
Last updated
06/08/2022
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