Individual
DR. EDWARD SALVATORE MORTELLARO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
710 OAKFIELD DR, SUITE 126, BRANDON, FL 33511-4938
(813) 685-7733
(813) 681-9723
Mailing address
710 OAKFIELD DR, SUITE 126, BRANDON, FL 33511-4938
(813) 685-7733
(813) 681-9723
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN 8061
FL
Other
Enumeration date
04/04/2013
Last updated
04/04/2013
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