Individual
JASMINE MCCAULLEY RENNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1747 US HIGHWAY 1 S, SAINT AUGUSTINE, FL 32084-4238
(904) 429-4647
Mailing address
1747 US HIGHWAY 1 S, SAINT AUGUSTINE, FL 32084-4238
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
10841
CT
1223G0001X
General Practice Dentistry
Primary
DN 22344
FL
Other
Enumeration date
08/09/2011
Last updated
11/11/2016
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