Provider Demographics
NPI:1861412389
Name:YOON, FLORENCE L (DDS)
Entity type:Individual
Prefix:DR
First Name:FLORENCE
Middle Name:L
Last Name:YOON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 W GRANADA BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8184
Mailing Address - Country:US
Mailing Address - Phone:386-672-2828
Mailing Address - Fax:386-672-1616
Practice Address - Street 1:1180 W GRANADA BLVD STE A
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8184
Practice Address - Country:US
Practice Address - Phone:386-672-2828
Practice Address - Fax:386-672-1616
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00111841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice