| NPI | 1366148942 |
|---|---|
| Doing Business As | DENTISTRY OF EAST COLONIAL LLC |
| Entity Type | Organization |
| Authorized Contact | CLEMENT JAMES CONTESTABLE Owner 321-356-5497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2023-04-25 |