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Organization

FUPS DENTAL, INC.

Active
Other names
One Day Denture
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CARLOS JAVIER SANTIAGO DDS (OWNER)
(904) 738-7735
Entity
Organization

Contact information

Practice address
1329 LANE AVE S STE 1, JACKSONVILLE, FL 32205-6111
(904) 683-0415
Mailing address
1329 LANE AVE S STE 1, JACKSONVILLE, FL 32205-6111
(904) 738-7856

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13959
FL

Other

Enumeration date
08/15/2012
Last updated
08/15/2012
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