| NPI | 1124343876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | P. DUDLEY GILES Owner/Physician 772-546-3223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME0083459) |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2010-04-06 |