| NPI | 1710119177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CHRIS BURNE Surgeon/CEO 941-423-1750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: FL DN18166) |
| Enumeration Date | 2009-08-19 |
| Last Update Date | 2009-08-19 |