| Organization Name: | DR. JOHN D VERVILLE, DDS, PA |
| NPI Number: | 1295102259 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN DENNIS VERVILLE (PRESIDENT) |
| Mailing Address: | 7055 Highway 17 Fleming Island |
| State: | FL US |
| Postal Code: | 320039317 |
| Phone Number: | 9042849911 |
| Fax Number: | 9042849915 |
| NPI Enumeration Date: | 08/26/2015 |
| NPI Last Update Date: | 08/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | DN12569 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |