| NPI | 1013354174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN JOHN FONTANA President 239-262-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2013-10-25 |