| NPI | 1114468394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CHARLES SAMPSON Owner/Dentist 727-940-6808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL 8609) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2017-03-20 |