is a Dental Clinic in Jacksonville, Florida. It is located at 12443 San Jose Blvd Ste 101, Jacksonville, FL and its contact number is 904-262-6188. The authorized person for is Dr. Brandon Lee Greenwalt
who is President of the clinic and their contact number is 317-408-5764. The primary license number for is DN19737 (General Practice) in Florida. Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Specialization:
General Practice Dentistry
Clinic Address:
12443 San Jose Blvd Ste 101, Jacksonville, Florida, 32223-8647
Phone:
904-262-6188
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Dr. Brandon Lee Greenwalt
Position:
President
Contact Number:
317-408-5764
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for clinic are as mentioned below.
NPI Number:
1154770733
NPI Enumeration Date:
06 Jun, 2016
NPI Last Update On:
06 Jun, 2016
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for are as mentioned below.
Specialization
License Number
State
Status
General Practice
DN19737
Florida
Primary
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
328 W Kari Ct, Jacksonville, Florida
Zip:
32259-3320
Phone Number:
317-408-5764
Patients can reach at 12443 San Jose Blvd Ste 101, Jacksonville, Florida or can call to book an appointment on 904-262-6188. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 February, 2025.