| NPI | 1487043659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERTO A. RUIZ Dentist 813-960-9080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 12062) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 13928) |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2015-01-12 |