| NPI | 1700183035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORI A ENZOR Dentist/Owner 941-365-3222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL 14434) |
| Enumeration Date | 2011-02-23 |
| Last Update Date | 2011-02-23 |