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Contact Information

SOUTH JACKSONVILLE DENTAL PLLC
8440 BLANDING BLVD
JACKSONVILLE, FL32244
 Phone: 904-525-8041
 Fax: 315-410-5531
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for SOUTH JACKSONVILLE DENTAL PLLC

NPI Number 1003287814
LBN Legal business name SOUTH JACKSONVILLE DENTAL PLLC
Authorized official KIM VAN CAMP - (PROVIDER RELATIONS SPECIALIST)
Entity Organization
Organization subpart 1 No
Enumeration date 10/20/2015
Last updated 10/20/2015 - About 11 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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