| NPI | 1699009688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY ANN MASTAPASCO Office Administrator 352-674-9077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN0011269) |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2009-09-24 |