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Individual

DR. JAN L. SPAGNOLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
55 N CARPENTER ROAD, TITUSVILLE, FL 32796
(321) 269-3802
(321) 269-0920
Mailing address
55 N. CARPENTER ROAD, TITUSVILLE, FL 32796
(321) 269-3802
(321) 269-0920

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN10166
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
450792
UNITED CONCORDIA
FL
01
60536
BCBS OF FLORIDA
FL
Enumeration date
08/02/2006
Last updated
11/15/2007
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