SpecialtyGeneral Dentist
LocationFernandina Beach, FL
NPI1073801510
License statusActive
License number21074
License expires02/28/2028
Disciplinary recordClear
Last verified by WhoIsMyDentist: 2026-07-17. Sourced from the U.S. federal NPI registry and state dental board licensing (federal record dated 03/12/2015). If this looks outdated, use "Report an issue" on this profile to suggest a correction.