| NPI | 1821000795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILLIAN RUTH BERRY President 727-584-4235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DN#9546) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2020-08-22 |