| NPI | 1689289621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN DAVID SHOOPAK President Owner 727-561-7666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2020-09-15 |