Individual
DR. GUSTAVO J WISCOVITCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6031 DR MARTIN LUTHER KING JR ST N, ST PETERSBURG, FL 33703-1139
(727) 521-6645
(727) 521-6648
Mailing address
6031 DR MARTIN LUTHER KING JR ST N, ST PETERSBURG, FL 33703-1139
(727) 521-6645
(727) 521-6648
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
0014499
FL
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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