Individual
DR. DANIEL BELOTSERKOVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10 SAINT JOHNS MEDICAL PARK DR, ST AUGUSTINE, FL 32086-5201
(904) 770-2686
Mailing address
10 SAINT JOHNS MEDICAL PARK DR, ST AUGUSTINE, FL 32086-5201
(904) 770-2686
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN21757
FL
Other
Enumeration date
05/30/2013
Last updated
02/06/2018
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