| NPI | 1780898817 |
|---|---|
| Doing Business As | SOUTHERN TRACE DENTAL |
| Entity Type | Organization |
| Authorized Contact | LINDA KEEVER HIGGS Office Manager 352-751-5777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |