| NPI | 1881310902 |
|---|---|
| Doing Business As | MAGNOLIA GREEN DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | ROBERT L DEMINT Credentialing Coordinator 813-692-2224 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2022-10-19 |