Organization
DR WIGGLESWORTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEANNA REBECCA WIGGLESWORTH DA (EXEC DIRECTOR)
(602) 865-9060
Entity
Organization
Contact information
Practice address
528 WATERWAY VILLAGE COURT, GREENACRES, FL 33413-0000
(602) 865-9060
Mailing address
PO BOX 542342, GREENACRES, FL 33454-0000
(602) 865-9060
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
07/30/2014
Last updated
07/30/2014
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