SpecialtyGeneral Dentist
LocationCrescent City, FL
NPI1740409291
License statusActive
License number9665
License expires02/28/2026
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 07/08/2007). If this looks outdated, use "Report an issue" on this profile to suggest a correction.