| NPI | 1154696789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY COLE Provider Relations 866-273-8204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN19418) |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2012-03-15 |