| NPI | 1023177094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAH THOMPSON GAGNON Doctor Of Dental Medicine 850-897-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN 17297) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2010-01-25 |