Provider Demographics
NPI:1871629238
Name:ETLING, JAMES C (DDS, PA)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:ETLING
Suffix:
Gender:M
Credentials:DDS, PA
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Mailing Address - Street 1:3228 SW MARTIN DOWNS BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-2679
Mailing Address - Country:US
Mailing Address - Phone:772-219-4212
Mailing Address - Fax:772-219-3599
Practice Address - Street 1:3228 SW MARTIN DOWNS BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-2679
Practice Address - Country:US
Practice Address - Phone:772-219-4212
Practice Address - Fax:772-219-3599
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLDN85061223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics