| NPI | 1760507008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD M. LEVINE President 813-935-3585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL 5871) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |