| Ideal Dental St Johns Pllc | |
|
145 Beachwalk Shore Dr Ste 400 St Johns FL 32259-1168 | |
| (904) 209-3042 | |
| Not Available |
| Full Name | Ideal Dental St Johns Pllc |
|---|---|
| Speciality | Dentist |
| Location | 145 Beachwalk Shore Dr Ste 400, St Johns, Florida |
| Authorized Official Name and Position | Matthew Doan (OWNER) |
| Authorized Official Contact | 9723318067 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ideal Dental St Johns Pllc Po Box 840925 Dallas TX 75284-0925 Ph: (972) 361-0600 | Ideal Dental St Johns Pllc 145 Beachwalk Shore Dr Ste 400 St Johns FL 32259-1168 Ph: (904) 209-3042 |
| NPI Number | 1073344917 |
|---|---|
| Provider Enumeration Date | 08/12/2024 |
| Last Update Date | 09/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073344917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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