Organization
JAX BEACHES FAMILY DENTISTRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE DEFELICE HUCKE DDS (PRESIDENT/CEO)
(904) 501-9178
Entity
Organization
Contact information
Practice address
802 3RD ST, NEPTUNE BEACH, FL 32266-5018
(904) 247-0111
Mailing address
802 3RD ST, NEPTUNE BEACH, FL 32266-5018
(904) 247-0111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN16151
FL
Other
Enumeration date
08/02/2014
Last updated
08/02/2014
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