| NPI | 1407226459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD KRAWCZYK Owner 727-785-0589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 10780) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2015-10-03 |
| Last Update Date | 2015-10-03 |