| NPI | 1841217668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE RITCHIE Office Manager 850-494-2292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN0011681) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2008-05-20 |