Individual
KEVIN R JURECKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2086 SW MAIN BLVD, SUITE #113, LAKE CITY, FL 32025-0005
(386) 758-6050
(386) 758-7742
Mailing address
2086 SW MAIN BLVD, SUITE #113, LAKE CITY, FL 32025-0005
(386) 758-6050
(386) 758-7742
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
0005418
FL
Other
Enumeration date
01/17/2007
Last updated
07/08/2007
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