MEDICARE: JAMES R HULFELD D.D.S., P.A.

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	DN 8547	FL

General Provider Information

NPI Number	:	1164540548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES R HULFELD D.D.S., P.A.

Provider Business Mailing Address
First Line	:	7451 103RD ST STE 18
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-6789
Country	:	US
Telephone Number	:	904-777-4622
Fax Number	:	904-777-5041

Provider Business Practice Location Address
First Line	:	7451 103RD ST STE 18
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-6789
Country	:	US
Telephone Number	:	904-777-4622
Fax Number	:	904-777-5041

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES R. HULFELD
Credential	:	D.D.S.
Telephone Number	:	904-777-4622

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	08/22/2020

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