| NPI | 1245633023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NILA PATEL Regional Manager 941-792-1447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN17880) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN16043) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2014-10-07 |