| NPI | 1053783209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ADAMS GREIDER Owner 239-222-2919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL 8703) |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2015-10-28 |