| NPI | 1881813756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW S JOHNSON Orthodontist 813-964-0828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL 12335) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |