| NPI | 1457449357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY MICHAEL MCMANAMA President 850-787-5186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN6222) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-08-22 |