| NPI | 1174662480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK WAYNE PEPIS Owner Dentist 904-731-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL 8595) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-08-22 |