| NPI | 1083099600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LICETTE F ESPINAL General Dentist 813-530-0991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: FL DN19212) |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2015-07-24 |