| NPI | 1063865673 |
|---|---|
| Former Legal Business Name | KENSINGTON DENTAL, LLC |
| Entity Type | Organization |
| Authorized Contact | MARNIE CHALL BAUER Owner 813-839-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2022-07-21 |