| NPI | 1750640686 |
|---|---|
| Doing Business As | BEACON FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | LEAH MARTIN Office Manager 904-641-0944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 10175) |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2012-05-12 |
| Last Update Date | 2019-08-28 |