| NPI | 1588944987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL A TARVER Owner 863-899-1617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN18670) |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2012-08-15 |