Individual
GEORGE LYNELL MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3615 DUPONT AVE STE 200-400, JACKSONVILLE, FL 32217-2790
(904) 714-6939
(904) 751-9196
Mailing address
3615 DUPONT AVE STE 200-400, JACKSONVILLE, FL 32217-2790
(904) 714-6939
(904) 751-9196
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN10795
FL
Other
Enumeration date
07/25/2018
Last updated
07/25/2018
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