| NPI | 1407967615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER CHARLES JANSON President 941-929-9580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL FL9242) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2008-07-25 |