| Palencia Dental | |
|
159 Palencia Village Dr Ste 107-109 St Augustine FL 32095-8457 | |
| (904) 826-4343 | |
| Not Available |
| Full Name | Palencia Dental |
|---|---|
| Speciality | Durable Medical Equipment & Medical Supplies - Customized Equipment |
| Location | 159 Palencia Village Dr Ste 107-109, St Augustine, Florida |
| Authorized Official Name and Position | Stephanie Kinsey (OWNER) |
| Authorized Official Contact | 9048264343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Palencia Dental 159 Palencia Village Dr Ste 107-109 St Augustine FL 32095-8457 Ph: (904) 826-4343 | Palencia Dental 159 Palencia Village Dr Ste 107-109 St Augustine FL 32095-8457 Ph: (904) 826-4343 |
| NPI Number | 1275193278 |
|---|---|
| Provider Enumeration Date | 06/20/2019 |
| Last Update Date | 06/20/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275193278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Secondary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (NU) | Primary |
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