Individual
DR. UTUMPORN LAOWANSIRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S, M.S.
Contact information
Practice address
3311 DANIELS RD STE 104, WINTER GARDEN, FL 34787-7000
(407) 656-0990
Mailing address
4150 EASTGATE DR APT 8203, ORLANDO, FL 32839-5238
(314) 541-9377
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN 20017
FL
Other
Enumeration date
04/17/2013
Last updated
04/11/2017
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