Individual
DR. JESSICA WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
480 N ORANGE AVE, APT 603, ORLANDO, FL 32801-1623
(903) 413-1648
Mailing address
480 N ORANGE AVE, APT 603, ORLANDO, FL 32801-1623
(903) 413-1648
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN 21891
FL
Other
Enumeration date
07/11/2016
Last updated
08/08/2016
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