| NPI | 1730747395 |
|---|---|
| Doing Business As | COASTAL JAW SURGERY - TAMPA |
| Entity Type | Organization |
| Authorized Contact | KATHERINE DIAZ Practice Administrator 727-709-1275 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2019-05-30 |