| NPI | 1871694786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD S. HANSEN President 850-932-4426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN11278) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-08-22 |