JONATHAN M NITISUSANTA

OCOEE, FL
NPI1134283252
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: FL  DN13138)
Enumeration Date2006-12-21
Last Update Date2007-07-08
Business Address
Dr. JONATHAN M NITISUSANTA DDS
2704 REW CIR SUITE103
OCOEE, FL 34761-2994
Phone number: 407-877-9003
Mailing Address
Dr. JONATHAN M NITISUSANTA DDS
10048 BRANDON CIR
ORLANDO, FL 32836-3714
Phone number: 407-877-9003