| NPI | 1811107485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY RICHARD FROUG Owner 941-795-0877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN0010494) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2008-06-25 |