| NPI | 1699506287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC WILLIAM RUSTEMIER Director/Owner Dentist 352-316-3701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2024-08-13 |
| Last Update Date | 2024-08-13 |