Provider Demographics
NPI:1194834812
Name:BOITET, DAYN COROT (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAYN
Middle Name:COROT
Last Name:BOITET
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1665 EAGLE HARBOR PARKWAY EAST
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32003-4802
Mailing Address - Country:US
Mailing Address - Phone:904-264-6700
Mailing Address - Fax:904-264-6855
Practice Address - Street 1:1665 EAGLE HARBOR PARKWAY EAST
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32003-4802
Practice Address - Country:US
Practice Address - Phone:904-264-6700
Practice Address - Fax:904-264-6855
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN8344332B00000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies