| NPI | 1679982243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAITLIN POL MCLAUGHLIN-RAIGER President 239-919-6930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL dn18551) |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2014-08-08 |