| NPI | 1699081919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT T. LAGGAN Oral & Maxillofacial Surgeon 850-478-7070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: FL DN 6078) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN18924) |
| 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: FL DN18924) | |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2011-04-12 |