| NPI | 1730726506 |
|---|---|
| Doing Business As | FISHHAWK MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | KATIE L MCCANN LEE Owner/Gp 813-563-8108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-11-29 |
| Last Update Date | 2022-08-25 |