Individual
JESSICA DU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
3098 W LAKE MARY BLVD, LAKE MARY, FL 32746
(407) 323-2300
Mailing address
304 LAKE AVE APT 315, MAITLAND, FL 32751-6319
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22060
FL
122300000X
Dentist
DS040998
PA
Other
Enumeration date
07/26/2016
Last updated
07/22/2019
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