Individual
ANNA ICHOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7280 STATE ROAD 54, NEW PORT RICHEY, FL 34653-6125
(727) 807-3355
Mailing address
7280 STATE ROAD 54, NEW PORT RICHEY, FL 34653-6125
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN25108
FL
Other
Enumeration date
07/28/2020
Last updated
07/28/2020
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