Individual
JAN F DELASSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1344 22ND ST S, ST PETERSBURG, FL 33712-2744
(727) 824-8177
(727) 551-9306
Mailing address
1344 22ND ST S, ST PETERSBURG, FL 33712-2744
(727) 824-8177
(727) 551-9306
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN18469
FL
Other
Enumeration date
07/30/2008
Last updated
07/30/2008
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