| NPI | 1598069239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT T. LAGGAN Oral & Maxillofacial Surgeon 850-478-7070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: FL DN18924) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN18924) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2011-04-20 |