| NPI | 1720098569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVETTE M FERNANDEZ President 941-639-1124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN15145) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2016-06-08 |