| NPI | 1376844951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY ROBERT SKUPNY President 352-246-3177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 18097) |
| Enumeration Date | 2010-11-12 |
| Last Update Date | 2010-11-12 |