| NPI | 1275036642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN GROOTERS Dentist/Owner 850-234-7080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN17955) |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2018-03-13 |