OrganizationActive
904 Implants and Dentures PLLC
NPI 1700549136 · Dental Clinic/Center · Jacksonville, FL
Provider details
- NPI number
- 1700549136
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- William Russell, Co-Owner(803) 665-6998
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
11645 Beach Blvd Ste 101
Jacksonville, FL 32246-8496
Phone: (904) 999-9000
Approximate (ZIP-level) locationGet directions
Mailing address
11645 Beach Blvd Ste 101
Jacksonville, FL 32246-8496
Registry dates
- Enumerated
- 2021-10-21
- Last updated
- 2021-10-21
- Certified
- 2021-10-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.