| NPI | 1750814166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY HEINECKE MASSEY Associate Dentist 352-796-0917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 22000) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN 22001) |
| 1223G0001X Dentist, General Practice (Licence: FL DN11090) | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2017-04-04 |