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General NPI Number Information
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NPI Number | 1033809272
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Entity Type | Individual
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Provider Name | DAVID GEORGE
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Gender | Male
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Dates
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Enumeration Date | 05/10/2023
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 1540 CORNERSTONE BLVD STE 100
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-7144
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Country | US
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Telephone | 386-243-9950
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Fax |
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Provider Business Mailing Address
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Address Line | 1035 CINNAMON FERN CT
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City | CASSELBERRY
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State | FL
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Zip | 32707-5812
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Country | US
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Telephone | 407-310-3464
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN28207
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 39869
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License Number State | TX
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