NPI | 1861556755 |
---|---|
Entity Type | Organization |
Authorized Contact | DON J. ILKKA President 352-430-1710 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 9239) |
Enumeration Date | 2006-12-22 |
Last Update Date | 2020-08-22 |