| NPI | 1104076447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DARRH BRYANT Dentist 850-878-6523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 16673) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2008-09-23 |