| NPI | 1710131826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK WAYNE MITCHELL President 727-842-5180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN10802) |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2008-11-17 |