| NPI | 1184802522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY SCOTT GOSLINGA President 386-462-1771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 17072) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2008-02-07 |