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Organization

BEAN SPROUT INC

Active
Other names
Bean Tree Pediatric Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JODI MASON DMD (PEDIATRIC DENTIST)
(904) 372-3260
Entity
Organization

Contact information

Practice address
2008 RIVERSIDE AVE, SUITE 101, JACKSONVILLE, FL 32204-4443
(904) 372-3260
(904) 385-3704
Mailing address
2008 RIVERSIDE AVE, SUITE 101, JACKSONVILLE, FL 32204-4443
(904) 372-3260
(904) 385-3704

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
17658
FL

Other

Enumeration date
01/08/2015
Last updated
01/08/2015
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