| NPI | 1225560519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY PAUL DILLING President/Dentist 239-454-1150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 18267) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2017-03-28 |