Individual
JYOTI BANSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2220 COUNTY ROAD 210 W STE 312, ST JOHNS, FL 32259-4059
(904) 825-9960
Mailing address
2307 W CLOVELLY LN, ST AUGUSTINE, FL 32092-5001
(904) 599-3981
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
01/17/2024
Last updated
01/17/2024
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