| NPI | 1033371646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY GRAPER Office Manager 352-331-6661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN5385) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2008-06-26 |