| NPI | 1841691664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EKATERINA MAKOVSKAYA Office Manager 727-789-4044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: FL 19865) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2014-09-11 |