RALPH WAYNE FORTSON

TAMPA, FL
NPI1568742021
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: FL  10042)
Enumeration Date2011-08-27
Last Update Date2011-08-27
Business Address
-- RALPH WAYNE FORTSON D.D.S.
10549 N FLORIDA AVE SUITE E
TAMPA, FL 33612-6707
Phone number: 813-935-3129
Mailing Address
-- RALPH WAYNE FORTSON D.D.S.
10549 N FLORIDA AVE SUITE E
TAMPA, FL 33612-6707
Phone number: 813-935-3129