| NPI | 1194927889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE J WALTERS President 850-763-8585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: FL DN0012432) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2020-08-22 |