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General NPI Number Information
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NPI Number | 1780172791
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Entity Type | Organization
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Legal Business Name | L & L DB, LLC
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Dates
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Enumeration Date | 04/25/2018
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Last Update Date | 04/25/2018
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Provider Practice Location Address
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Address Line | 1540 CORNERSTONE BLVD SUITE 100
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City | DAYTONA BEACH
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State | FL
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Zip | 32117
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Country | US
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Telephone | 386-243-9950
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Fax | 386-319-9099
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Provider Business Mailing Address
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Address Line | 3890 TURTLE CREEK DRIVE SUITE A
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City | PORT ORANGE
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State | FL
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Zip | 32127
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Country | US
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Telephone | 386-761-5440
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Fax | 386-760-0474
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. EUGENE JOSEPH LECOMPTE JR.
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Credential | DDS, MS
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Telephone | 386-295-3815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DN12922
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DN7283
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License Number State | FL
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