| NPI | 1093914426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA MOORE Insurance Billing 813-968-7228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 10427) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2007-07-16 |