MEDICARE: DR. SHARMILLA ANAND DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN0013665	FL

General Provider Information

NPI Number	:	1144398595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARMILLA ANAND DMD

Provider Business Mailing Address
First Line	:	1420 SAN MARCO BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207
Country	:	US
Telephone Number	:	904-399-3632
Fax Number	:	904-399-1674

Provider Business Practice Location Address
First Line	:	1420 SAN MARCO BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207
Country	:	US
Telephone Number	:	904-399-3632
Fax Number	:	904-399-1674

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2006
Last Update Date	:	06/24/2008

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