Individual
DERRICK L MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1036-42 DUNN AVE, JACKSONVILLE, FL 32218-6359
(904) 714-9909
Mailing address
3869 ELOISE ST, JACKSONVILLE, FL 32205-8943
(202) 294-8872
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN18598
FL
Other
Enumeration date
05/18/2012
Last updated
05/18/2012
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