| NPI | 1104198282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD MERRELL WILLIAMS CEO 813-299-3867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN012810) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-02-03 |