| NPI | 1457410946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | T. MERRELL WILLIAMS President 813-354-8707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL Dn 12810) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2020-08-22 |