| NPI | 1740721976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK J MOKRIS President 352-514-0413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: FL DN18060) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2017-03-20 |