Organization
BOLD CITY DENTISTRY, PA
Active
Other names
Aspen Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MIKA WEISS (PROVIDER RELATIONS)
(315) 454-6000
Entity
Organization
Contact information
Practice address
463859 STATE ROAD 200, YULEE, FL 32097-3639
(315) 454-6000
(315) 438-4483
Mailing address
463859 STATE ROAD 200, YULEE, FL 32097-3639
(315) 454-6000
(315) 438-4483
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN19347
FL
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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