NPI | 1265918312 |
---|---|
Entity Type | Organization |
Authorized Contact | HOLLY KAY Vice President 727-251-1907 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: FL DN11998) |
Additional Taxonomies | 122300000X Dentist (Licence: FL dn19345) |
122300000X Dentist (Licence: FL dn19494) | |
Enumeration Date | 2018-07-12 |
Last Update Date | 2018-07-12 |