Organization
SOUTH VILLAGE DENTAL, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER PARKS (SENIOR ACCOUNT SPECIALIST)
(904) 998-7000
Entity
Organization
Contact information
Practice address
339 COLONY BLVD, THE VILLAGES, FL 32162-6084
(904) 998-7000
Mailing address
3545 SAINT JOHNS BLUFF RD S # 352, JACKSONVILLE, FL 32224-2682
(904) 998-7000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/11/2017
Last updated
08/11/2017
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