PHENNATDA POLPORNVITOON

PORT CHARLOTTE, FL
NPI1568082030
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: FL  DN25388)
Additional Taxonomies122300000X Dentist
(Licence: FL  DN25388)
Enumeration Date2020-04-24
Last Update Date2022-06-10
Business Address
PHENNATDA POLPORNVITOON
18000 TOLEDO BLADE BLVD
PORT CHARLOTTE, FL 33948-1980
Phone number: 941-740-8598
Mailing Address
PHENNATDA POLPORNVITOON
18000 TOLEDO BLADE BLVD
PORT CHARLOTTE, FL 33948-1980
Phone number: 954-383-8362