Healthcare Provider Details

I. General information

NPI: 1649199944
Provider Name (Legal Business Name): BLISSFUL DENTAL GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6672 THOMASVILLE RD STE 3
TALLAHASSEE FL
32312-4142
US

IV. Provider business mailing address

6672 THOMASVILLE RD STE 3
TALLAHASSEE FL
32312-4142
US

V. Phone/Fax

Practice location:
  • Phone: 850-203-4143
  • Fax:
Mailing address:
  • Phone: 850-203-4143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTONIA COLLINS
Title or Position: PHYSICIAN
Credential: DMD
Phone: 352-222-0783