| NPI | 1245687060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN SHIVELER Dentist/Owner 850-321-4964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN19010) |
| Enumeration Date | 2016-05-22 |
| Last Update Date | 2016-05-22 |