Individual provider · NPI-1

Joann Weatherwax, DH

Dental Hygienist · Kissimmee, FL

NPI number1699709493
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1699709493
Entity type
Individual (NPI-1)
Name
Joann Weatherwax
Credential
DH
Sex
Female
Sole proprietor
No
Enumeration date
Jul 10, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
124Q00000X Dental HygienistDH15237FLYes

Practice location

1875 Boggy Creek Rd
Kissimmee, FL 34744

Phone 407-343-2003 · Fax 407-892-6468

Mailing address

1050 Grape Ave
St Cloud, FL 34769

Phone 407-343-2003 · Fax 407-892-6468

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