| NPI | 1063671428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MICHAEL MICHAUD President 813-935-3585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN17693) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2008-06-02 |