| NPI | 1235471590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON EDWARDS President 813-528-8999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN16709) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2013-03-25 |