| 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 |