| NPI | 1104251701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN JAKUBAITIS President 941-629-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL 11468) |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2013-10-04 |