Provider Demographics
NPI:1235492158
Name:ARLINGTON DENTAL HOLDINGS INC
Entity Type:Organization
Organization Name:ARLINGTON DENTAL HOLDINGS INC
Other - Org Name:AFFORDABLE DENTAL CENTER OF JACKSONVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:GAFF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:904-379-7053
Mailing Address - Street 1:6416 ARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-5411
Mailing Address - Country:US
Mailing Address - Phone:904-379-7053
Mailing Address - Fax:
Practice Address - Street 1:6416 ARLINGTON RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-5411
Practice Address - Country:US
Practice Address - Phone:904-379-7053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL59071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty