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1134283252
JONATHAN M NITISUSANTA
OCOEE, FL
NPI
1134283252
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: FL DN13138)
Enumeration Date
2006-12-21
Last Update Date
2007-07-08
Business Address
Dr. JONATHAN M NITISUSANTA DDS
2704 REW CIR SUITE103
OCOEE, FL 34761-2994
Phone number: 407-877-9003
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Mailing Address
Dr. JONATHAN M NITISUSANTA DDS
10048 BRANDON CIR
ORLANDO, FL 32836-3714
Phone number: 407-877-9003
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