| NPI | 1235761008 |
|---|---|
| Doing Business As | WILDERNESS OAK FAMILY DENTISTRY @ 281 |
| Entity Type | Organization |
| Authorized Contact | VIVIANA VAZQUEZ Director Of Operations 813-244-0958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-02-10 |