| NPI | 1053488684 |
|---|---|
| Doing Business As | HAINES CITY DENTAL |
| Entity Type | Organization |
| Authorized Contact | JAMES P COSTELLO President 352-408-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2020-08-22 |