| NPI | 1457775165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL QUINLAN Dentist 850-932-0831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223E0200X Dentist Endodontics | |
| 1223P0221X Dentist Pediatric Dentistry | |
| 1223P0300X Dentist Periodontics | |
| 122400000X Denturist | |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| 126900000X Dental Laboratory Technician | |
| Enumeration Date | 2014-02-17 |
| Last Update Date | 2014-02-17 |