| NPI | 1467949016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES JOHN HORAN Owner/Dentist 772-324-8939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2018-11-29 |