| NPI | 1508952482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERVIN PATRICK ARDOIN Owner 941-748-7983 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL 10871) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |