| NPI | 1942021514 |
|---|---|
| Former Legal Business Name | MICHAEL VERSAGGI DDS |
| Former Legal Business Name | VERSAGGI DENTAL |
| Entity Type | Organization |
| Authorized Contact | JONATHAN AALONA MONTOYA Owner 904-829-9024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-10-17 |
| Last Update Date | 2024-10-17 |