| NPI | 1073586228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD MERRELL WILLIAMS Owner President 813-354-8707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN12810) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2011-12-28 |