Individual
JOANN WEATHERWAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DH
Contact information
Practice address
1875 BOGGY CREEK RD, KISSIMMEE, FL 34744
(407) 343-2003
(407) 892-6468
Mailing address
1050 GRAPE AVE, ST CLOUD, FL 34769
(407) 343-2003
(407) 892-6468
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH15237
FL
Other
Enumeration date
07/10/2006
Last updated
07/08/2007
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