| NPI | 1487707204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARYN MARTINO Insurance COO Rdinator 941-474-6466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN9203) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |