904 Implants and Dentures PLLC
Organization Active NPI Dental Clinic/Center · Jacksonville, FL
NPI 1700549136 · NPPES record last updated Oct 21, 2021
Key facts
- NPI
- 1700549136
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- Legal business name
- 904 IMPLANTS AND DENTURES PLLC
- Practice address
- 11645 Beach Blvd Ste 101
Jacksonville, FL 32246-8496 - Phone
- (904) 999-9000
- NPI assigned
- Oct 21, 2021
- Organization subpart
- No
Authorized official
- Name
- Dr. William Russell, DMD
- Title
- Co-Owner
- Phone
- (803) 665-6998
Practitioners 2
-
Alex McRee, DMD
-
William Russell, DMD
National Provider Directory
Locations
11645 Beach Blvd
Ste 101
Jacksonville, FL 32246
Phone (904) 999-9000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Yes |
Addresses
Primary practice location
11645 Beach Blvd Ste 101
Jacksonville, FL 32246-8496
Mailing address
11645 Beach Blvd Ste 101
Jacksonville, FL 32246-8496
Phone (904) 999-9000
Other providers in Jacksonville, FL
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- 3D Smile Inc
- 5888 Golden LLC
- 5TH Essentials LLC
- 904 Health, Inc
- 9355 San Jose Boulevard Operations LLC
- A & R Support Services LLC
- A & S Home Caring Inc
- A 1 Complete Care LLC
- A a Anointed Care
All providers in Jacksonville, FL · Dental Clinic/Center in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2021. 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.