| NPI | 1144537564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAN MOURSELAS Dentist 239-261-7291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN16793) |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2010-09-07 |