Organization
DR JOHN RUMBLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DACHIA RENEE COOPER (ORTHODONTIST ASST)
(904) 398-8970
Entity
Organization
Contact information
Practice address
4521 ATLANTIC BLVD, JACKSONVILLE, FL 32207-1137
(904) 398-8790
(904) 346-3595
Mailing address
4521 ATLANTIC BLVD, JACKSONVILLE, FL 32207
(904) 398-8970
(904) 346-3595
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
073948100
—
FL
Enumeration date
10/08/2015
Last updated
12/17/2015
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