| NPI | 1235523069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH J THOMAS President 772-713-3720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN12247) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 015111) |
| 122300000X Dentist (Licence: KS 6609) | |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2015-03-18 |