| NPI | 1740603380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JADE E. THOMAS Owner 772-344-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN16485) |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2014-02-03 |