Provider Demographics
NPI:1629182738
Name:DECOCKER, LINDA PAPCUM (DDS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:PAPCUM
Last Name:DECOCKER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:PAPCUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:9200 B NAVARRE PKWY
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566
Mailing Address - Country:US
Mailing Address - Phone:850-939-6040
Mailing Address - Fax:
Practice Address - Street 1:9200 B NAVARRE PKWY
Practice Address - Street 2:NAVARRE FAMILY DENTISTRY
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566
Practice Address - Country:US
Practice Address - Phone:850-939-6040
Practice Address - Fax:850-939-1553
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL136241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice