| NPI | 1053525402 |
|---|---|
| Former Legal Business Name | EAST LAKE CENTER FOR COSMETIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CHARLES W. SCHMIDT President 941-365-1717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN8986) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |