AVALON DENTAL CLINIC PL NPI 1629045489

NPI Information

  • NPI: 1629045489
  • Provider Name: AVALON DENTAL CLINIC PL
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 4272 AVALON BOULEVARD
    MILTON, FL
    ZIP 32583
  • Phone: (850) 626-6100

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NPI Details

AVALON DENTAL CLINIC PL is a general practice dentist in Milton, FL. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. AVALON DENTAL CLINIC PL NPI is 1629045489. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4272 AVALON BOULEVARD
MILTON, FL
ZIP 32583-858
Phone: (850) 626-6100
Fax: (850) 626-6161

The provider's authorized official is Anissa Marie Rodriquez-ottley .
The authorized official title is Owner and has the following contact phone number (850) 626-6100.

The enumeration date for this NPI number is 3/1/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeDN15481FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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