Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 12012376A | IN |
NPI | 1124401641 |
---|---|
Provider Name | Dr. John Arkel Westres |
First Address | Orlando, FL 32812-2331 |
Second Address | Orlando, FL 32812-2331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2015 |
Last Update Date | 23/09/2016 |