Broc Flores, Dmd, P.A
Clinic/Center, Dental in Jacksonville, FL. Organization (NPI-2).
NPI number1043935596
StatusActive
Last updated in NPPESOct 6, 2022
Details
- NPI
- 1043935596
- Entity type
- Organization (NPI-2)
- Legal business name
- Broc Flores, Dmd, P.A
- Organization subpart
- No
- Enumeration date
- Oct 6, 2022
- Certification date
- Oct 6, 2022
- Last updated
- Oct 6, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- Ortega Dental (Doing Business As)
Practice location
5911 Timuquana Rd Ste 202Jacksonville, FL 32210-8174
Phone 904-553-8114
Mailing address
1592 Glendale StJacksonville, FL 32205-8925
Phone 904-553-8114
Authorized official
Broc Flores
Owner
9045538114
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