| NPI | 1427169085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE COLE Insurance Director 727-726-1611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 6164) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2013-10-10 |