Individual
DR. JOSEPH MICHAEL MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
964 AJAX ST, JACKSONVILLE, FL 32214-0130
(904) 546-7100
Mailing address
964 AJAX STREET, JACKSONVILLE, FL 32214-0001
(904) 546-7100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11552303-9921
UT
Other
Enumeration date
12/12/2019
Last updated
09/12/2023
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