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General NPI Number Information
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NPI Number | 1467452151
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Entity Type | Organization
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Legal Business Name | JACKSONVILLE UNIVERSITY SCHOOL OF ORTHODONTICS
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Dates
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Enumeration Date | 07/26/2005
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 2800 UNIVERSITY BLVD N
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City | JACKSONVILLE
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State | FL
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Zip | 32211-3321
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Country | US
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Telephone | 904-256-7847
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Fax | 904-256-7889
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Provider Business Mailing Address
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Address Line | 2800 UNIVERSITY BLVD N
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City | JACKSONVILLE
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State | FL
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Zip | 32211-3321
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Country | US
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Telephone | 904-256-7847
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Fax | 904-256-7889
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. MARK ALARBI
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Credential | D.D.S.
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Telephone | 904-256-7847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DTP449
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License Number State | FL
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