| NPI | 1679888952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER ROBERT LEWIS WOOD President 904-807-9825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN11181) |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2010-08-11 |