NPI | 1154807600 |
---|---|
Entity Type | Organization |
Authorized Contact | PATTY REYER Office Manager 772-567-2111 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 19761) |
Enumeration Date | 2018-07-18 |
Last Update Date | 2018-07-18 |