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Organization

BEACHES ORTHODONTICS, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEVIN W. O'SHAUGHNESSY D.M.D., M.S. (PRESIDENT)
(904) 273-5570
Entity
Organization

Contact information

Practice address
330 AIA NORTH, SUITE 326, PONTE VEDRA BEACH, FL 32082
(904) 273-5570
(904) 273-8518
Mailing address
330 AIA NORTH, SUITE 326, PONTE VEDRA BEACH, FL 32082
(904) 273-5570
(904) 273-8518

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN16801
FL

Other

Enumeration date
07/27/2010
Last updated
07/27/2010
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