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General NPI Number Information
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NPI Number | 1780934497
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Entity Type | Organization
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Legal Business Name | AA PRIME CARE DENTAL ASSOCIATES
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Dates
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Enumeration Date | 09/11/2012
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Last Update Date | 09/11/2012
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Provider Practice Location Address
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Address Line | 12276 SAN JOSE BLVD SUITE 101
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City | JACKSONVILLE
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State | FL
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Zip | 32223-8628
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Country | US
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Telephone | 904-886-3342
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 441376
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City | JACKSONVILLE
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State | FL
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Zip | 32222-0014
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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 | PRESIDENT
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Name | DR. DANIEL P ALNITI
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Credential | D.D.S.
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Telephone | 904-886-3342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN14991
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License Number State | FL
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