NPI | 1760085930 |
---|---|
Entity Type | Organization |
Authorized Contact | ANDREW CROUCH VP 321-872-8820 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice |
Additional Taxonomies | 1223P0300X Dentist Periodontics |
Enumeration Date | 2020-11-19 |
Last Update Date | 2020-11-19 |