| NPI | 1700627981 |
|---|---|
| Doing Business As | EAGLE HARBOR DENTAL |
| Entity Type | Organization |
| Authorized Contact | KELLY THERESA STANDISH-MAYO Dentist / Owner 904-269-6558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-06-03 |
| Last Update Date | 2024-10-03 |