| NPI | 1669640710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY C. METCALFE President 386-775-9366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN12754) |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2008-02-12 |