| NPI | 1285758839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIAMAK RAFIEIAN Owner Dentist 727-786-9144 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN13918) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN3904) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2017-04-25 |