| NPI | 1356767610 |
|---|---|
| Doing Business As | HANCOCK VILLAGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | EDWIN ACOSTA President 352-989-5815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 19583) |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2014-03-11 |