| NPI | 1568878387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEY LYNN BORDERS President Dentist 813-334-3798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN16284) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2014-07-02 |