| NPI | 1699893115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES E JENKINSS Treasurer 941-366-4553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN0013723) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN0014316) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |