Individual
DR. BETHANY ANN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
9109 BAYMEADOWS RD STE 2, JACKSONVILLE, FL 32256-1842
(904) 265-1242
Mailing address
1060 OAKVALE RD, ST JOHNS, FL 32259-3823
(904) 671-3799
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
DN014001
GA
1223E0200X
Endodontics
Primary
DN19093
FL
Other
Enumeration date
10/14/2009
Last updated
02/03/2022
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