| NPI | 1134524424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE J MEADOWS Managing Member 941-745-1143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2014-10-29 |