| NPI | 1033631528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA SMITH Office Manager 850-378-6233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AL 4968) |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2017-07-17 |