Organization
JOHN W FAUL, DMD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN W FAUL D.M.D. (PRESIDENT)
(321) 626-7725
Entity
Organization
Contact information
Practice address
7435 STATE ROAD 21, SUITE B, KEYSTONE HEIGHTS, FL 32656-9301
(352) 473-8988
Mailing address
140 SW GROVE ST, KEYSTONE HEIGHTS, FL 32656-9526
(321) 626-7725
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN08155
FL
Other
Enumeration date
05/22/2007
Last updated
12/07/2011
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