| NPI | 1699152041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GISELA GUERRERO Office Manager 239-992-8555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: FL DN19591) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2015-05-05 |