NPI | 1598789158 |
---|---|
Entity Type | Organization |
Authorized Contact | JASON GARY SEYMOUR President Of Corporation 850-682-4724 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN0014058) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN0014029) |
Enumeration Date | 2006-07-27 |
Last Update Date | 2020-08-22 |