Individual provider · Type 1 NPI
John Willaim Thousand Iv, DDS
Periodontics · Palm Coast, FL
NPI number
1972990752
Active
Practice location
3 Cypress Branch Way
Palm Coast, FL 32164-8409
Mailing address
980 Windward Way
St. Augustine, FL 32080-6182
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Periodontics Primary | 1223P0300X | 00201869 (CO) |
Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
2 other providers at this address
About NPI 1972990752
John Willaim Thousand Iv, DDS's National Provider Identifier is 1972990752, issued on Apr 20, 2015. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Palm Coast, FL. The record was last updated on Feb 25, 2016.