| NPI | 1821148297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN CHARLES MILLER Owner 727-561-0555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN 15709) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2015-09-23 |