| NPI | 1275084204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODRIGO NEIVA Periodontology Program Director 352-273-7846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN-22055) |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2016-10-14 |