Individual
DR. IAN FAWCETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1054 N BROADWAY AVE, BARTOW, FL 33830-3301
(863) 614-1804
Mailing address
1054 N BROADWAY AVE, BARTOW, FL 33830-3301
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN 20245
FL
Other
Enumeration date
07/02/2013
Last updated
07/02/2013
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