| NPI | 1477664266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH ALAN HUTCHINSON Owner 727-461-9149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN13680) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-03-22 |