| NPI | 1568666576 |
|---|---|
| Doing Business As | THE DENTIST |
| Entity Type | Organization |
| Authorized Contact | JAMES P COSTELLO President 352-408-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2020-08-22 |