Organization
BLUE SKY DENTAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONAS ASHBAUGH DDS (CEO)
(904) 229-5794
Entity
Organization
Contact information
Practice address
14866 OLD ST. AUGUSTINE RD, SUITE 111 AND 112, JACKSONVILLE, FL 32288
(904) 229-5794
Mailing address
14866 OLD ST. AUGUSTINE RD, SUITE 111 AND 112, JACKSONVILLE, FL 32288
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN21709
FL
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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