| NPI | 1740524446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN ERIC BERRY President 850-481-1969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN16280) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2014-09-16 |