| NPI | 1063620789 |
|---|---|
| Doing Business As | FAMILY DENTISTRY OF FLORIDA, COUNTYLINE |
| Entity Type | Organization |
| Authorized Contact | IGOR PASISNITCHENKO Member 305-654-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN15470) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2020-08-22 |