NPI | 1548434087 |
---|---|
Entity Type | Organization |
Authorized Contact | MARY I PORTER Doctor/Owner 941-371-3006 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 9698) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 13121) |
1223G0001X Dentist, General Practice (Licence: FL 16728) | |
Enumeration Date | 2008-04-16 |
Last Update Date | 2008-04-16 |