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Individual

DR. DAVID WALLACE SORENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
460 TOWN PLAZA AVE, SUITE 210, PONTE VEDRA, FL 32081-5139
(904) 395-7771
Mailing address
460 TOWN PLAZA AVE STE 210, PONTE VEDRA, FL 32081-5140
(904) 395-7771

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN20719
FL

Other

Enumeration date
08/12/2014
Last updated
01/06/2021
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