| NPI | 1770700437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD S MORTELLARO President 813-685-7733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN8061) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2020-08-22 |