| NPI | 1114291002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY RASKA President 941-923-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN18583) |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2012-02-24 |