| NPI | 1073735478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT MILLER Financial Manager 727-797-5161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |