| NPI | 1821127549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN N TAYLOR Oral Surgeon 904-261-6068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN13187) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |