| NPI | 1104365246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS KINCAID MCCAWLEY President 954-522-3228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN5447) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: FL DN20065) |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2017-02-22 |