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General NPI Number Information
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NPI Number | 1952704280
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Entity Type | Organization
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Legal Business Name | ELIZABETH ALFUENTE, DMD, PLLC
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Dates
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Enumeration Date | 10/01/2014
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Last Update Date | 10/01/2014
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Provider Practice Location Address
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Address Line | 12777 ATLANTIC BLVD STE #26
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City | JACKSONVILLE
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State | FL
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Zip | 32225-7120
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Country | US
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Telephone | 904-221-3550
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Fax | 904-221-3227
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Provider Business Mailing Address
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Address Line | 12777 ATLANTIC BLVD STE #26
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City | JACKSONVILLE
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State | FL
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Zip | 32225-7120
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Country | US
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Telephone | 904-221-3550
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Fax | 904-221-3227
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Authorized Official
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Title or Position | MEMBER
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Name | DR. ELIZABETH ALFUENTE
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Credential | DMD
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Telephone | 904-221-3550
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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 | DN18628
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License Number State | FL
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