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1568742021
RALPH WAYNE FORTSON
TAMPA, FL
NPI
1568742021
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: FL 10042)
Enumeration Date
2011-08-27
Last Update Date
2011-08-27
Business Address
-- RALPH WAYNE FORTSON D.D.S.
10549 N FLORIDA AVE SUITE E
TAMPA, FL 33612-6707
Phone number: 813-935-3129
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Mailing Address
-- RALPH WAYNE FORTSON D.D.S.
10549 N FLORIDA AVE SUITE E
TAMPA, FL 33612-6707
Phone number: 813-935-3129
Copy
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