| NPI | 1518294669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTINA MALLERY Owner/Provider Of Services 941-748-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN18531) |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2009-11-11 |