| NPI | 1861267676 |
|---|---|
| Other Name | NA |
| Entity Type | Organization |
| Authorized Contact | MICHAEL WAYNE ROWE Owner 727-327-7151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2023-11-21 |
| Last Update Date | 2024-11-04 |