| Coast Dental-anastasia Island | |
|
1081 A1a Beach Blvd St Augustine FL 32080-6733 | |
| (904) 471-3291 | |
| (904) 471-3783 |
| Full Name | Coast Dental-anastasia Island |
|---|---|
| Speciality | Dentist |
| Location | 1081 A1a Beach Blvd, St Augustine, Florida |
| Authorized Official Name and Position | Melody Rivera (CREDENTIALING MANAGER) |
| Authorized Official Contact | 8133507166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coast Dental-anastasia Island 5706 Benjamin Center Dr Ste 103 Tampa FL 33634-5262 Ph: (813) 288-1999 | Coast Dental-anastasia Island 1081 A1a Beach Blvd St Augustine FL 32080-6733 Ph: (904) 471-3291 |
| NPI Number | 1821664178 |
|---|---|
| Provider Enumeration Date | 05/27/2021 |
| Last Update Date | 05/27/2021 |
| Certification Date | 05/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821664178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (NU) | Primary |
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