| NPI | 1003191180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KURK L. MALWIN Business Manager 941-488-1459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN12353) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2014-01-28 |