| NPI | 1740707835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE I KRAFT Office Manager 352-331-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN11078) |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2022-07-21 |