| NPI | 1871718668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ANTONY STIPANOV President 941-739-8303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN0011911) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2013-10-17 |