| NPI | 1063924512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN J KRAUSE Owner 863-773-9344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN18310) |
| Enumeration Date | 2017-10-24 |
| Last Update Date | 2017-10-24 |