| NPI | 1295977098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY BAKER Office Manager 813-719-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN17074) |
| Enumeration Date | 2009-03-26 |
| Last Update Date | 2009-03-26 |