| NPI | 1053332080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN BARR HULEN Owner 863-385-8422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN0010207) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2020-08-22 |