| NPI | 1205969722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW J MARTINEAU Director 941-957-3703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN12356) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2012-01-10 |