NPI | 1790812865 |
---|---|
Entity Type | Organization |
Authorized Contact | BILLY GENE WHITEHEAD Owner 727-441-8963 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2007-02-27 |
Last Update Date | 2020-08-22 |