| NPI | 1790947984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HAROLD MCMILLAN President 239-549-5590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 9676) |
| Enumeration Date | 2008-06-28 |
| Last Update Date | 2008-06-28 |