Provider Demographics
NPI:1851688543
Name:MOLINA, YUNIOR (DDS)
Entity Type:Individual
Prefix:
First Name:YUNIOR
Middle Name:
Last Name:MOLINA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:YUNIOR
Other - Middle Name:
Other - Last Name:MOLINA RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10950 SAN JOSE BLVD STE 64
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-6671
Mailing Address - Country:US
Mailing Address - Phone:904-260-4244
Mailing Address - Fax:
Practice Address - Street 1:10950 SAN JOSE BLVD STE 64
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-6671
Practice Address - Country:US
Practice Address - Phone:904-260-4244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN207311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice