| NPI | 1659794956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY ALAN HAMEROFF Owner/President 352-596-1771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL 10916) |
| Enumeration Date | 2014-01-23 |
| Last Update Date | 2014-01-23 |