NPI | 1326389883 |
---|---|
Entity Type | Organization |
Authorized Contact | TODD L. SHARP Owner 239-573-2326 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 122300000X Dentist |
1223E0200X Dentist, Endodontics | |
1223P0300X Dentist, Periodontics | |
1223S0112X Dentist, Oral and Maxillofacial Surgery | |
124Q00000X Dental Hygienist | |
126800000X Dental Assistant | |
Enumeration Date | 2013-03-08 |
Last Update Date | 2013-03-08 |