Varnado, Phillis W

Varnado, Phillis W is an individual health care provider with primary practice located at 515 W 6Th St , Jacksonville FL 32206-4324. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Varnado, Phillis W can be contacted via phone (904) 253-1210.

Contact Information

Primary practice address
515 W 6Th St Jacksonville FL 32206-4324
Fax: (904) 253-1956
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DN10404 Florida

Profile Details

NPI number 1265486260
LBN Legal business name Varnado, Phillis W
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2006
Last updated Feb 26th, 2013 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265486260 NPPES
Florida MEDICAID 070437700
Florida MEDICAID 0704377-00

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