Organization
WILTON MANORS DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALEXANDRA GUTERSOHN-MCCOY (OFFICE MANAGER)
(954) 564-4746
Entity
Organization
Contact information
Practice address
2517 NE 9TH AVE, WILTON MANORS, FL 33305-1284
(954) 564-4746
Mailing address
2517 NE 9TH AVE, WILTON MANORS, FL 33305-1284
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
DN18173
FL
Other
Enumeration date
06/23/2014
Last updated
06/24/2014
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