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Individual

BANG QUACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D., MD.

Contact information

Practice address
653-1 W 8TH ST FL 2, JACKSONVILLE, FL 32209-6511
(904) 244-3689
Mailing address
783 BRITTANY DR APT C, INDIALANTIC, FL 32903-2039
(773) 226-4368

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DN22840
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DEN2000300
DC
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN123045
GA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN22840
FL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
02/27/2017
Last updated
08/08/2023
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