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Organization
JRDENTAL,INC
Active
Organization
JRDENTAL,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OBDULIA DOLORES RONDON DMD (PRESIDENT)
(904) 613-3375
Entity
Organization
Contact information
Practice address
1329 LANE AVE S STE 1, JACKSONVILLE, FL 32205-6111
(904) 786-5850
(904) 786-3101
Mailing address
1329 LANE AVE S STE 1, JACKSONVILLE, FL 32205-6111
(904) 786-5850
(904) 786-3101
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075633400
—
FL
Enumeration date
10/05/2006
Last updated
07/03/2014
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