Individual
DAISY ALICIA FATJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
5138 DEER PARK DR, SUITE #102, NEW PORT RICHEY, FL 34653-7027
(727) 372-1481
(727) 372-1754
Mailing address
5138 DEER PARK DR, SUITE #102, NEW PORT RICHEY, FL 34653-7027
(727) 372-1481
(727) 372-1754
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN 18642
FL
Other
Enumeration date
07/23/2009
Last updated
11/26/2013
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