Avalon Dental Clinic PL
Organization Active NPI General Practice Dentistry · Milton, FL
NPI 1629045489 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1629045489
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DN15481 (FL)
- Legal business name
- AVALON DENTAL CLINIC PL
- Practice address
- 4272 Avalon Boulevard
Milton, FL 32583-2858 - Phone
- (850) 626-6100
- Fax
- (850) 626-6161
- NPI assigned
- Mar 1, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Anissa Marie Rodriquez-Ottley, DMD
- Title
- Owner
- Phone
- (850) 626-6100
Practitioners 2
-
Mike H Marcantonio, DMD
-
Anissa R Ottley, DMD
National Provider Directory
Locations
4272 Avalon Blvd
Milton, FL 32583
Phone (850) 626-6100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | DN15481 | FL | Yes |
Addresses
Primary practice location
4272 Avalon Boulevard
Milton, FL 32583-2858
Mailing address
4272 Avalon Boulevard
Milton, FL 32583-2858
Phone (850) 626-6100
Other providers in Milton, FL
- Cynthia Ard
- Holly R Arland
- Rebecca Ates
- Dennis Umali Atienza
- Kathleen Lynn Atwill
- Angela Marie Avery
- Jocquelynn Michele Bailey
- Henry Nash Baker III
- Justin Dean Baker
- Kim Baker
All providers in Milton, FL · General Practice Dentistry in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.