| NPI | 1730412701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN C. RICHARD VP 941-928-2490 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN18201) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN18531) |
| 122300000X Dentist (Licence: FL DN17733) | |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2009-09-09 |