| NPI | 1518122928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD TIMOTHY MCINTOSH President 352-854-6663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL 11315) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2008-07-24 |