| NPI | 1013376219 |
|---|---|
| Doing Business As | MID BAY DENTAL |
| Entity Type | Organization |
| Authorized Contact | JUSTINE KONANE CHASE Owner 850-897-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN14797) |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2022-02-04 |