| NPI | 1205143419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARY WAYNE STIMSON President 727-738-1716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2010-09-09 |