| NPI | 1235440884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA STILLEY Periodontist 727-847-1239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN17194) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: FL DN6888) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2010-06-29 |