| NPI | 1225760556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES THOMAS CANNON Owner/Dentist 941-539-9718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2023-03-10 |