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General NPI Number Information
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NPI Number | 1568621621
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Entity Type | Organization
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Legal Business Name | FIRST CARE DENTAL ASSOCIATES, P.A.
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Dates
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Enumeration Date | 06/04/2008
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Last Update Date | 06/04/2008
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Provider Practice Location Address
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Address Line | 2274 WEDNESDAY ST
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4334
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Country | US
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Telephone | 850-309-0970
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Fax |
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Provider Business Mailing Address
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Address Line | 2274 WEDNESDAY ST
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4334
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. TOYIA CHENISE LUNN
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Credential |
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Telephone | 850-309-0970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DN10204
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License Number State | FL
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