| NPI | 1003469313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN C GARRUGIA Doctor 850-505-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-07-17 |