| NPI | 1265756571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ROY THOUSAND Owner/Periodontist 386-445-4242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN7967) |
| Enumeration Date | 2010-03-16 |
| Last Update Date | 2010-03-16 |