| NPI | 1376350082 |
|---|---|
| Doing Business As | DEEP ROOTS DENTAL AND FACIAL ASETHETICS LLC |
| Entity Type | Organization |
| Authorized Contact | MARNIE CHALL BAUER Owner 813-839-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-12-16 |
| Last Update Date | 2024-12-16 |