| NPI | 1144638602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL SIMMONS Doctor/Owner 850-698-3304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN19981) |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2014-07-29 |