| NPI | 1649648627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES T. CANNON Owner/Dentist 941-539-9718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN15542) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2015-09-09 |