| NPI | 1871730317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD H. COPENHAVER Owner 727-822-2228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: FL 6749) |
| Enumeration Date | 2009-01-20 |
| Last Update Date | 2010-07-13 |