| NPI | 1659596088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID C NEAL Physician 863-294-7648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN0005273) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN15279) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2020-08-22 |