Individual
DIPAL MAHAJAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 FULKERSON WAY, ST AUGUSTINE, FL 32086-0450
(904) 770-4580
Mailing address
50 FULKERSON WAY, ST AUGUSTINE, FL 32086-0450
(904) 770-4580
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30599
FL
Other
Enumeration date
06/25/2025
Last updated
06/25/2025
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