Organization
ECONOMY DENTISTRY DUPONT STATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEROY RONALD POLITE D.M.D (PRESIDENT)
(904) 714-6939
Entity
Organization
Contact information
Practice address
3615 DUPONT AVE, 200-400, JACKSONVILLE, FL 32217-2790
(904) 714-6939
(904) 751-9196
Mailing address
3615 DUPONT AVE, 200-400, JACKSONVILLE, FL 32217-2790
(904) 714-6939
(904) 751-9196
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN8243
FL
Other
Enumeration date
12/26/2012
Last updated
12/26/2012
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