| NPI | 1558757526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM WESTBERRY Dentist/Owner 386-423-1440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223D0001X Dentist, Dental Public Health | |
| 1223E0200X Dentist, Endodontics | |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223P0300X Dentist, Periodontics | |
| 1223P0700X Dentist, Prosthodontics | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X0008X Dentist, Oral and Maxillofacial Radiology | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2025-04-23 |