| NPI | 1629433800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN MATHEW KORATTIYIL Dentist 941-923-7060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN18851) |
| Enumeration Date | 2015-12-15 |
| Last Update Date | 2015-12-15 |