| NPI | 1417961376 |
|---|---|
| Former Legal Business Name | GULF COAST DENTAL CARE PA |
| Entity Type | Organization |
| Authorized Contact | JENNIFER M COVINGTON Office Manager 228-832-3231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2024-06-06 |