Provider Demographics
NPI:1235162330
Name:MAVEC, JOSEPH CHARLES (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CHARLES
Last Name:MAVEC
Suffix:
Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:822 A1A N
Mailing Address - Street 2:SUITE 314
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-3260
Mailing Address - Country:US
Mailing Address - Phone:904-273-5770
Mailing Address - Fax:904-273-5720
Practice Address - Street 1:822 A1A N
Practice Address - Street 2:SUITE 314
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-3260
Practice Address - Country:US
Practice Address - Phone:904-273-5770
Practice Address - Fax:904-273-5720
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLDN163921223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics