Derry Gushen Agnini, D.D.S. Valid NPI

Individual provider · Orthodontics and Dentofacial Orthopedics Dentistry · Davenport, FL

NPI

1417283649

Type

Individual (Type 1)

Primary specialty

Orthodontics and Dentofacial Orthopedics Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223X0400X

License number

DN 16647 (FL)

Sex

Female

Sole proprietor

Yes

Enumerated

2009-10-22

Last updated

2010-02-25