| NPI | 1407792948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN DAVID SHOOPAK Owner 727-522-5599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2026-04-27 |
| Last Update Date | 2026-04-27 |