| NPI | 1104090943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE Y GERRY President 386-362-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN14223) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2008-04-14 |