| NPI | 1053332379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY ROYAL SELBY Doctor 813-654-0037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 5777) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-08-22 |