| NPI | 1033525431 |
|---|---|
| Other Name | DESTIN DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | HENRY PAUL KELLUM Owner 850-837-6645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL 10931) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2014-07-07 |