Mertz, Kenneth A

Mertz, Kenneth A is an individual health care provider with primary practice located at 1722 University Blvd. , Jacksonville FL 32216. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dental Public Health, Dental Providers / General Practice. Dental Providers / Dental Public Health is his primary health care specialty. Mertz, Kenneth A can be contacted via phone (904) 253-1240.

Contact Information

Primary practice address
1722 University Blvd. Jacksonville FL 32216
Phone: (904) 253-1240
Fax: (904) 727-6548
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Public Health 1223D0001X DN15901 Florida
Dental Providers / General Practice 1223G0001X DN15901 Florida

Profile Details

NPI number 1003882184
LBN Legal business name Mertz, Kenneth A
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated Feb 26th, 2013 - about 11 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 1003882184 NPPES
Georgia MEDICAID 801488195A
Georgia MEDICAID 075717900
Georgia MEDICAID 0757179-00

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