| NPI | 1841815818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL D. HANSON Owner/Dentist 850-785-7273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2020-06-15 |