| NPI | 1114073590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK B MOSS Owner 727-393-6024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN6079) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN16886) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-08-22 |