Individual
DR. CORDARYL LEE WHITEHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12517 YELLOW BLUFF RD, JACKSONVILLE, FL 32226-3809
(904) 204-7496
Mailing address
9743 WATERSHED DR S, JACKSONVILLE, FL 32220-0903
(205) 496-2310
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN28351
FL
Other
Enumeration date
07/11/2023
Last updated
07/17/2023
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