| NPI | 1710285739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES W MEDLOCK President 561-439-4620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN 10346) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2011-03-14 |