| NPI | 1316119795 |
|---|---|
| Doing Business As | MAGNOLIA DENTAL |
| Entity Type | Organization |
| Authorized Contact | JAMES P COSTELLO Member 352-408-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2008-03-26 |