| NPI | 1356149546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE CARIDE Credentialing Mgr 727-784-2721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-03-04 |
| Last Update Date | 2025-03-04 |