| NPI | 1508939927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID S PETRIK President Of Corporation 727-442-4646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN 13150) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |