| NPI | 1275673683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORA ELENA JARQUIN Dentist 941-345-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN14594) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |