BOULDER ROCK DENTAL LLC NPI 1922515204

NPI Information

BOULDER ROCK DENTAL, LLC is a general practice dentist in Palm Coast, 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. BOULDER ROCK DENTAL, LLC NPI is 1922515204. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5 BOULDER ROCK DR STE A
PALM COAST, FL
ZIP 32137-538
Phone: (386) 931-1685

The provider's authorized official is Tanya Whitaker .
The authorized official title is Office Manager and has the following contact phone number (386) 931-1685.

The enumeration date for this NPI number is 1/8/2018 and was last updated on 1/8/2018.

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:

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