| NPI | 1003191099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER D ROBINSON President / Periodontist 904-737-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN17364) |
| Enumeration Date | 2011-10-21 |
| Last Update Date | 2011-10-21 |