| NPI | 1609391655 |
|---|---|
| Doing Business As | ST. AUGUSTINE CENTER FOR DENTAL EXCELLENCE |
| Entity Type | Organization |
| Authorized Contact | CRYSTAL LOVE WHITE Regional Manager 904-323-5293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2017-08-11 |
| Last Update Date | 2022-07-21 |