| NPI | 1588002620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEOFFREY A JACKSON CEO/Owner 352-871-2577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN18870) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2013-06-11 |