| NPI | 1194197632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA M MATHEWS Business Manager 352-344-4747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN18310) |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2015-10-23 |