| NPI | 1629481221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN A WHITSITT Owner 386-239-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN10669) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2014-06-11 |