| NPI | 1861601379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS EDWARD SHAW President 813-752-7058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN9316) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |