| NPI | 1265867972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANG V HA CEO 813-498-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN17217) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN17953) |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2013-09-12 |