| NPI | 1053972661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY HOPKINSON Executive Director 321-514-4992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2019-06-25 |