| NPI | 1023556388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY ANNE EDWARDS Mgrm 813-545-9081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN19077) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2017-02-07 |