SpecialtyDentist
LocationDaytona Beach, FL
NPI1639273279
License statusActive
License number12289
License expires02/28/2028
Disciplinary recordOn file
Last verified by WhoIsMyDentist: 2026-07-17. Sourced from the U.S. federal NPI registry and state dental board licensing (federal record dated 11/15/2011). If this looks outdated, use "Report an issue" on this profile to suggest a correction.