Provider Demographics
NPI:1336449545
Name:MCALPIN DENTAL GROUP P.A.
Entity Type:Organization
Organization Name:MCALPIN DENTAL GROUP P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCALPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-269-1048
Mailing Address - Street 1:2301 PARK AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073
Mailing Address - Country:US
Mailing Address - Phone:904-269-1048
Mailing Address - Fax:904-269-0109
Practice Address - Street 1:2301 PARK AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073
Practice Address - Country:US
Practice Address - Phone:904-269-1048
Practice Address - Fax:904-269-0109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN80081223G0001X
FLDN182781223G0001X
FLDN107731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1194975219OtherNPI ENUMERAATOR
FL1710901046OtherNPI ENUMERATOR
FL1770634222OtherNPI ENUMERATOR