Individual provider · Type 1 NPI
Daniel Kuruvilla
Pediatric Dentistry · Yulee, FL
NPI number
1902482003
Active
Practice location
463725 State Road 200 Ste 3
Yulee, FL 32097-8671
Fax (904) 347-2611
Mailing address
625 Elmwood Ave
Rochester, NY 14620-2913
Other practice locations
- 196 Everest Ln Ste 1, St. Johns, FL 32259-4103 · (904) 584-9004
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | None listed |
| Pediatric Dentistry Primary | 1223P0221X | DN26484 (FL) |
Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
About NPI 1902482003
Daniel Kuruvilla's National Provider Identifier is 1902482003, issued on Mar 20, 2021. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Yulee, FL. The record was last updated on Sep 1, 2023.