| NPI | 1841942489 |
|---|---|
| Other Name | IMAGINE ST. PETE |
| Entity Type | Organization |
| Authorized Contact | MARIELLA CARRENO Office Manager 863-462-4463 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2022-01-25 |