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Daniel Kuruvilla
Pediatric Dentist in Yulee, Florida
NPI 1902482003

Daniel Kuruvilla is a Pediatric Dentist based in Rochester, FL and is specialized in Pediatric Dentistry. Daniel Kuruvilla practices in Yulee, FL. The NPI Number for Daniel Kuruvilla is 1902482003 and holds a License No. (Florida).

The current practice location address for Daniel Kuruvilla is 463725 State Road 200 Ste 3, Yulee, FL and can be reached out via phone at 904-584-9004 and via fax at 904-347-2611.

Location: 463725 State Road 200 Ste 3, Yulee, FL, 14620-2913
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1902482003
Provider Name
Daniel Kuruvilla
Credential
Provider Entity Type
Individual
Gender
Male
Address
463725 State Road 200 Ste 3, Yulee, FL, 14620-2913
Phone Number
904-584-9004
Fax Number
904-347-2611
Provider Enumeration Date
03/20/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
463725 State Road 200 Ste 3
City
Yulee
State
Florida
Zip
32097-8671
Phone Number
904-584-9004
Fax Number
904-347-2611
person
Provider Business Mailing Address Details
Address
463725 State Road 200 Ste 3
City
Yulee
State
Florida
Zip
32097-8671
Phone Number
904-584-9004
Fax Number
904-347-2611
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
DN26484 (Florida)
Definition
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.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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