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General NPI Number Information
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NPI Number | 1932719960
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Entity Type | Organization
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Legal Business Name | ADEGIL PLLC
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 8206 PHILIPS HWY SUITE 21
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City | JACKSONVILLE
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State | FL
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Zip | 32256
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Country | US
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Telephone | 904-425-1212
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Fax | 904-425-1535
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Provider Business Mailing Address
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Address Line | 8206 PHILIPS HWY SUITE 21
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City | JACKSONVILLE
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State | FL
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Zip | 32256
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Country | US
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Telephone | 904-425-1212
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Fax | 904-425-1535
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Authorized Official
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Title or Position | MEMBER
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Name | DR. DHAVAL Y SHAH
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Credential | DMD
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Telephone | 904-425-1212
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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 |
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License Number State |
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