| NPI | 1467880070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE LAND Office Manager 813-929-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN17707) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: FL DN18381) |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2013-10-16 |