| NPI | 1790810935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN DAVID SHOOPAK Owner 727-522-5599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2017-10-06 |