| NPI | 1841698883 |
|---|---|
| Other Name | AMELIA ISLAND PERIODONTICS |
| Entity Type | Organization |
| Authorized Contact | MICHELLE E HOUGLAND Practice Administrator 904-273-4373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN14294) |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2019-01-07 |