| NPI | 1205206679 |
|---|---|
| Doing Business As | A FAMILY DENTIST |
| Entity Type | Organization |
| Authorized Contact | MAI THI NGUYEN Office Manager 813-642-8885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2015-09-29 |