Individual
JOHANNA MARIA PERALTA PERALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
5170 DAVE ROBBINS WAY, LAKELAND, FL 33812-4348
(863) 808-4037
Mailing address
5018 APEX CIR APT 408, DAVENPORT, FL 33837-2312
(787) 317-4046
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
28507
FL
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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