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NPI Code Detail

MEDICARE: AGERICO M SAYOC DMD MSD PA

MEDICARE: AGERICO M SAYOC DMD MSD PA
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
11223P0700XProsthodonticsDN10831FL

General Provider Information

NPI Number : 1255470936
Entity Type Code : Organization
Provider Name (Legal Business Name) : AGERICO M SAYOC DMD MSD PA
Provider Business Mailing Address
First Line : 13167 ATLANTIC BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32225-3125
Country : US
Telephone Number : 904-221-0054
Fax Number : 904-221-0049
Provider Business Practice Location Address
First Line : 13167 ATLANTIC BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32225-3125
Country : US
Telephone Number : 904-221-0054
Fax Number : 904-221-0049
Authorized Official
Title or Position : PRESIDENT DENTIST
Name : AGERICO M SAYOC
Credential :
Telephone Number : 904-221-0054
Provider Enumeration Date : 02/06/2007
Last Update Date : 06/13/2013

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Directions to “AGERICO M SAYOC DMD MSD PA ” Practice Location

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