Individual
ITI AGARWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5840 GULF BREEZE PKWY, GULF BREEZE, FL 32563-9571
(850) 934-4074
Mailing address
2855 MAGNOLIA AVE, PENSACOLA, FL 32503-4875
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
24667
FL
1223G0001X
General Practice Dentistry
8718
SC
Other
Enumeration date
07/03/2014
Last updated
03/30/2020
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