Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Boulder Rock Dental, LLC

Organization General Practice Dentistry · NPI 1922515204

Boulder Rock Dental, LLC is a General Practice Dentistry in Palm Coast, Florida. Licensed in Florida. Registered with an NPI since 2018.

Licensed in
FL
In the registry since
2018
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5 Boulder Rock Dr Ste A
Palm Coast, FL 32137-8538
Phone: (386) 931-1685
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence DN15016 (FL)

Record details

NPI number1922515204
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tanya Whitaker — Office Manager · (386) 276-9051
NPI enumeratedJanuary 8, 2018
Last updated in NPPESJune 12, 2024
Certification dateJune 12, 2024
Mailing address5 Boulder Rock Dr Ste A, Palm Coast, FL 32137-8538

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