Provider Demographics
NPI:1154462521
Name:ALL, DAVID EARL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EARL
Last Name:ALL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 DELTONA BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-7128
Mailing Address - Country:US
Mailing Address - Phone:386-574-5497
Mailing Address - Fax:386-574-1438
Practice Address - Street 1:780 DELTONA BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-7128
Practice Address - Country:US
Practice Address - Phone:386-574-5497
Practice Address - Fax:386-574-1438
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN142491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice