| NPI | 1104491877 |
|---|---|
| Doing Business As | PANTHER HOLLOW DENTAL LODGE |
| Entity Type | Organization |
| Authorized Contact | ASHLEY NICOLE YOUNKMAN-REYNOLDS Owner/Dentist 941-661-1044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-05-25 |
| Last Update Date | 2021-05-25 |