| NPI | 1306223888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN M WOOLSEY Periodontist 850-678-6485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN21004) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2015-05-04 |