| NPI | 1255366894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE MUSSER Owener 863-665-8878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: FL DN 7401) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2008-11-18 |