Individual
DR. JOHN WILLARD FAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1111 S DIXIE FWY, NEW SMYRNA BEACH, FL 32168-7473
(386) 424-1631
Mailing address
1648 TAYLOR RD # 457, PORT ORANGE, FL 32128-6753
(321) 626-7725
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
008155
FL
Other
Enumeration date
12/08/2014
Last updated
12/08/2014
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