| NPI | 1417373762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM NICHOLAS SULLIVAN Owner 239-597-4944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN14951) |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2014-03-11 |