| NPI | 1154935799 |
|---|---|
| Doing Business As | ST. LUCIE WEST DENTAL SPECIALISTS |
| Entity Type | Organization |
| Authorized Contact | MIKHAIL GANKIN Owner 772-348-4403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2020-09-01 |