| NPI | 1700987732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW ELLISON TRAMMELL Owner Dentist Secretary Officer 850-477-5252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2008-01-18 |