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NPI Code Detail

MEDICARE: MRS. DAWN VONDERAU RDH

MEDICARE: MRS. DAWN VONDERAU RDH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1124Q00000XDental HygienistDH12675FL

General Provider Information

NPI Number : 1841593209
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DAWN VONDERAU RDH
Provider Business Mailing Address
First Line : 611 E ADAMS ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32202-2847
Country : US
Telephone Number : 904-394-8060
Fax Number :
Provider Business Practice Location Address
First Line : 611 E ADAMS ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32202-2847
Country : US
Telephone Number : 904-394-8060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2010
Last Update Date : 12/07/2010

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Directions to “ MRS. DAWN VONDERAU RDH” Practice Location

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