| NPI | 1669697025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER T JOHNSON Owner 352-242-0627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN14869) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2012-10-18 |