Individual
DR. ANTHONY RAY BRAZIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
554 KEILY STREET, BUREAU OF MED AND SURGERY, CENTRALIZED CRED AND PRIV, JACKSONVILLE, FL 32312
(757) 953-7011
Mailing address
554 KEILY STREET, BUREAU OF MED AND SURGERY, CENTRALIZED, JACKSONVILLE, FL 32312
(757) 953-7011
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE 60494136
WA
Other
Enumeration date
10/03/2014
Last updated
10/03/2014
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