| NPI | 1609241918 |
|---|---|
| Doing Business As | BEACON FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | LEAH MARTIN Office Manager 904-641-0944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL DN10175) |
| Enumeration Date | 2015-12-11 |
| Last Update Date | 2019-07-22 |