| NPI | 1144343948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH CHARLES MANTIONE Dentist Owner 727-381-6929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL dn15699) |
| Enumeration Date | 2007-04-08 |
| Last Update Date | 2020-08-22 |