Organization
ORTHO 99 PLUS 1 ORANGE PARK LLC
Active
Organization
ORTHO 99 PLUS 1 ORANGE PARK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN MCDANIEL DMD (OWNER)
(352) 494-2676
Entity
Organization
Contact information
Practice address
950 BLANDING BLVD STE 20, ORANGE PARK, FL 32065-5911
(904) 619-7140
Mailing address
14536 PLUMOSA DR, JACKSONVILLE BEACH, FL 32250-2222
(352) 494-2676
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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