| NPI | 1770974313 |
|---|---|
| Former Legal Business Name | EMERALD COAST DENTAL SLEEP MEDICINE |
| Entity Type | Organization |
| Authorized Contact | TARA GRIFFIN CEO 850-249-9331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic (Licence: FL ME0093485) |
| Additional Taxonomies | 261Q00000X (Licence: FL DN17668) |
| 261QD0000X Clinic/Center, Dental (Licence: FL DN17668) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL DN17668) | |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2015-06-05 |