| Blossom Dental and Facial Aesthetics | |
|
900 W Granada Blvd Ste 5 Ormond Beach FL 32174-5941 | |
| (386) 947-7603 | |
| (352) 639-5688 |
| Full Name | Blossom Dental and Facial Aesthetics |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 900 W Granada Blvd Ste 5, Ormond Beach, Florida |
| Authorized Official Name and Position | Huda Aljonaidy (OWNER) |
| Authorized Official Contact | 9546843432 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blossom Dental and Facial Aesthetics 900 W Granada Blvd Ste 5 Ormond Beach FL 32174-5941 Ph: (386) 947-7603 | Blossom Dental and Facial Aesthetics 900 W Granada Blvd Ste 5 Ormond Beach FL 32174-5941 Ph: (386) 947-7603 |
| NPI Number | 1841754603 |
|---|---|
| Provider Enumeration Date | 01/25/2019 |
| Last Update Date | 01/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841754603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | () | Secondary |
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