OrganizationActive
Bold City Dentistry, PA
NPI 1902201064 · General Practice Dentistry · Yulee, FL
Provider details
- NPI number
- 1902201064
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Mika Weiss, Provider Relations(315) 454-6000
- License
- DN19347 (FL)
Specialties & taxonomies
Dental Providers
Practice location
463859 State Road 200
Yulee, FL 32097-3639
Phone: (315) 454-6000
Fax: (315) 438-4483
Approximate (ZIP-level) locationGet directions
Mailing address
463859 State Road 200
Yulee, FL 32097-3639
Other names (DBA / former)
- Doing business as
- Aspen Dental
Registry dates
- Enumerated
- 2014-10-30
- Last updated
- 2014-10-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.