NPI | 1083867584 |
---|---|
Entity Type | Organization |
Authorized Contact | GLENDA M CALEY Secretary 772-299-4179 |
Organization Subpart ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN14498) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: FL DN16531) |
Enumeration Date | 2008-10-28 |
Last Update Date | 2008-10-28 |