| NPI | 1689230104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE COLE VP Insurnace Plan Management 727-424-2990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2023-11-29 |