| NPI | 1316966385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL ALLEN PALO CEO 863-294-7605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN0012379) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2009-07-28 |