| NPI | 1487897575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEROY R POLITE Owner 904-696-6767 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 8243) |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2009-04-20 |