Organization
DISTINCTIVE DENTISTRY OF SANFORD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER WEISBRUCH DDS (OWNER)
(407) 330-1700
Entity
Organization
Contact information
Practice address
200 W LAKE MARY BLVD, SANFORD, FL 32773-5925
(407) 330-1700
Mailing address
200 W LAKE MARY BLVD, SANFORD, FL 32773-5925
(407) 330-1700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9352
FL
Other
Enumeration date
01/13/2007
Last updated
08/22/2020
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