Individual
DR. JOEL RUSSELL WADSWORTH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
13940 N US HIGHWAY 441, SUITE 602, LADY LAKE, FL 32159-8908
(352) 750-0008
(352) 259-9145
Mailing address
PO BOX 3817, BELLEVIEW, FL 34421-3817
(352) 750-0008
(352) 259-9145
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN14051
FL
Other
Enumeration date
09/25/2006
Last updated
11/18/2009
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