NPI | 1609278068 |
---|---|
Former Legal Business Name | PELICAN DENTAL, PLLC |
Entity Type | Organization |
Authorized Contact | WILLIAM ERIC SACKHEIM Owner Dentist 850-476-2602 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN18697) |
Enumeration Date | 2014-09-17 |
Last Update Date | 2019-07-24 |