Organization
BOB W. DEASON, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOB DEASON DDS (OWNER/PRESIDENT)
(904) 724-6321
Entity
Organization
Contact information
Practice address
765 MILL CREEK RD, JACKSONVILLE, FL 32211-6432
(904) 724-6321
(904) 721-6151
Mailing address
765 MILL CREEK RD, JACKSONVILLE, FL 32211-6432
(904) 724-6321
(904) 721-6151
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN6332
FL
Other
Enumeration date
01/18/2010
Last updated
01/18/2010
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