| NPI | 1215014337 |
|---|---|
| Former Legal Business Name | PRESTIGE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | TRACEY J WILKE Financial COO Rdinator 727-376-3763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |