| NPI | 1780717280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DITMAR WISSEL President 352-622-2911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN10997) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-11-20 |