Blue Water Dental of St Johns
Blue Water Dental of St Johns is a Preferred Provider Organization in Ponte Vedra, Florida. Licensed in Florida. Registered with an NPI since 2016.
- Licensed in
- FL
- In the registry since
- 2016
Practice location Address checks out
460 Town Plaza Ave Ste 210Ponte Vedra, FL 32081-5139
Phone: (904) 755-1966
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Preferred Provider Organization (primary) | Taxonomy 305R00000X · Licence DN20719 (FL) |
|---|
Record details
| NPI number | 1821543513 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | David Sorensen — Dentist/Owner · (904) 755-1966 |
| NPI enumerated | August 23, 2016 |
| Last updated in NPPES | August 23, 2016 |
| Mailing address | 334 Willow Winds Pkwy, Saint Johns, FL 32259-7268 |