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Blue Water Dental Of St. Johns
Preferred Provider Organization in Ponte Vedra, Florida
NPI 1821543513

Blue Water Dental Of St. Johns is a Preferred Provider Organization based in Saint Johns, FL. Blue Water Dental Of St. Johns practices in Ponte Vedra, FL. The NPI Number for Blue Water Dental Of St. Johns is 1821543513 and holds a License No. DN20719 (Florida).

The current practice location address for Blue Water Dental Of St. Johns is 460 Town Plaza Ave, Ponte Vedra, FL and can be reached out via phone at 904-755-1966.

Location: 460 Town Plaza Ave, Ponte Vedra, FL, 32259-7268
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1821543513
Provider Name
Blue Water Dental Of St. Johns
Credential
Provider Entity Type
Organization
Address
460 Town Plaza Ave, Ponte Vedra, FL, 32259-7268
Phone Number
904-755-1966
Fax Number
Provider Enumeration Date
08/23/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1831508084 01 FL INDIVIDUAL NPI
institution
Provider Business Practice Location Address Details
Address
460 Town Plaza Ave
City
Ponte Vedra
State
Florida
Zip
32081-5139
Phone Number
904-755-1966
Fax Number
person
Provider Business Mailing Address Details
Address
460 Town Plaza Ave
City
Ponte Vedra
State
Florida
Zip
32081-5139
Phone Number
904-755-1966
Fax Number
person
Provider's Taxonomy Details 1
Type
Managed Care Organizations
Classification
Preferred Provider Organization
Speciality
-
Taxonomy
305R00000X
License No.
DN20719 (Florida)
Definition
A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.
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