| 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 |