| NPI | 1568233138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN ASKELAND Owner 772-349-4226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2024-06-27 |