| NPI | 1659452886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J. HUNTER COLLINS Doctor 321-725-6565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 14275) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 14467) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |