| NPI | 1841495124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINGER R CHASOLEN Owner Partner 941-957-0073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: FL DN13735) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: FL DN13718) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2020-08-22 |