| NPI | 1275203796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN CLAUSSEN CEO 863-291-5110 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2025-05-15 |