Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DN22269 | FL |
NPI | 1013120310 |
---|---|
Provider Name | Dr. Angela Willox |
First Address | Ocoee, FL 34761-4750 |
Second Address | Ocoee, FL 34761-4750 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 02/06/2019 |