Individual
JEAN PAUL TAVERAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1251 ARIANA ST, LAKELAND, FL 33803-1814
(813) 420-1950
Mailing address
2211 MOUNTAIN MEADOW WAY, VALRICO, FL 33594-5136
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN22694
FL
Other
Enumeration date
06/12/2017
Last updated
06/12/2017
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