| NPI | 1114851797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN PASICZNYK Owner 239-946-1881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2026-06-10 |
| Last Update Date | 2026-06-10 |