| NPI | 1487149167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT DELBOCCIO Owner/Dentist 239-304-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2018-06-26 |