| NPI | 1336518331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL O'NEILL MEADOR Dentist 850-712-5024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AL 5789) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AL 5811) |
| Enumeration Date | 2015-09-20 |
| Last Update Date | 2015-09-20 |