Provider Demographics
NPI:1902984222
Name:VANN, JOSLYN A (DDS)
Entity Type:Individual
Prefix:MISS
First Name:JOSLYN
Middle Name:A
Last Name:VANN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JOSLYN
Other - Middle Name:A
Other - Last Name:VANN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:2166 CASSAT AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-4157
Mailing Address - Country:US
Mailing Address - Phone:904-384-5700
Mailing Address - Fax:904-384-0581
Practice Address - Street 1:2166 CASSAT AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-4157
Practice Address - Country:US
Practice Address - Phone:904-384-5700
Practice Address - Fax:904-384-0581
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN166311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice