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General NPI Number Information
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NPI Number | 1144415209
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Entity Type | Individual
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Provider Name | DAWIT ADUGNA DDS
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Gender | Male
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 02/24/2012
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Provider Practice Location Address
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Address Line | 5000 US HWY. 17 S. SUITE 4
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City | ORANGE PARK
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State | FL
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Zip | 32073
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Country | US
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Telephone | 951-536-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 9036 TIMBERLIN LAKE RD
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City | JACKSONVILLE
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State | FL
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Zip | 32256-5431
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Country | US
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Telephone | 951-536-2200
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401411912
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7699
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN 19646
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License Number State | FL
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