| NPI | 1669794608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK D THURSTON Owner 863-967-7548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 8413) |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2010-02-18 |