| NPI | 1093062630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY COLE Provider Relations Manager 866-273-8204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN17338) |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2012-08-14 |