| NPI | 1487380705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT L DEMINT Credentialing COO Rdinator 813-692-2224 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2022-07-28 |