| NPI | 1760317291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN STROUT Owner 904-806-2037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2026-06-16 |
| Last Update Date | 2026-06-16 |