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Individual

DR. JAGDEEP DHALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
430 WAYMONT CT, LAKE MARY, FL 32746-6745
(724) 840-5066
Mailing address
430 WAYMONT CT, LAKE MARY, FL 32746-6745
(724) 840-5066

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DN23561
FL
1223G0001X
General Practice Dentistry
Primary
DN23561
FL

Other

Enumeration date
07/06/2018
Last updated
07/03/2020
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