| NPI | 1639337983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY R. CHESLOCK President 727-799-1564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 6316) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2008-05-22 |