| NPI | 1275742538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN J. DELISLE President 727-398-5829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN0011245) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2013-11-15 |