| NPI | 1598811754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL BELTON GASKINS President 904-744-4522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL 11982) |
| Enumeration Date | 2007-01-28 |
| Last Update Date | 2020-08-22 |