| NPI | 1568890036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUG Q NGUYEN Owner/Dentist 813-903-9877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN13930) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN13967) |
| Enumeration Date | 2013-10-21 |
| Last Update Date | 2013-10-21 |