| NPI | 1184360620 |
|---|---|
| Doing Business As | PARK AVENUE DENTAL |
| Entity Type | Organization |
| Authorized Contact | MICHAEL A SHERMAN President/Owner 904-269-5520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2022-05-09 |