Provider Demographics
NPI:1477445328
Name:MOBILE DENTAL XPRESS MANAGEMENT GROUP LLC
Entity type:Organization
Organization Name:MOBILE DENTAL XPRESS MANAGEMENT GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-300-0126
Mailing Address - Street 1:1839 LANE AVE S STE 104
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-1260
Mailing Address - Country:US
Mailing Address - Phone:904-300-0126
Mailing Address - Fax:877-770-3699
Practice Address - Street 1:1839 LANE AVE S STE 104
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-1260
Practice Address - Country:US
Practice Address - Phone:904-300-0126
Practice Address - Fax:877-770-3699
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOBILE DENTAL XPRESS MANAGEMENT GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty