| NPI | 1548027204 |
|---|---|
| Other Name | DEEP ROOTS PROJECT LLC |
| Entity Type | Organization |
| Authorized Contact | JENNIFER NICOLE VEGA Practice Manager 813-839-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-02-29 |
| Last Update Date | 2024-02-29 |