| NPI | 1457751653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NILA PATEL Office Manager 813-909-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN16043) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN16415) |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2014-08-26 |