NPI | 1073941084 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMI STRANIGAN Administration 772-340-0805 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: FL DN11707) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
122300000X Dentist (Licence: FL DN14820) | |
122300000X Dentist (Licence: FL DN15672) | |
124Q00000X Dental Hygienist (Licence: FL DH19254) | |
124Q00000X Dental Hygienist (Licence: FL DH1940) | |
124Q00000X Dental Hygienist (Licence: FL DH19138) | |
Enumeration Date | 2013-10-30 |
Last Update Date | 2022-02-17 |