| NPI | 1528053923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMMY MARTIN THOMSON Partner 352-373-7373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 7024) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2008-06-17 |