| NPI | 1164932356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J YU Managing Member 727-894-1442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2019-06-21 |