Individual
DANELYS LEYVA CHACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
450031 STATE ROAD 200, CALLAHAN, FL 32011-3847
(904) 879-1893
Mailing address
450031 STATE ROAD 200, CALLAHAN, FL 32011-3847
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN28963
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2024
Last updated
06/14/2024
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