| NPI | 1417475732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY R PETRONE Owner/Dentist 850-212-1286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN19821) |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2022-07-21 |