| NPI | 1891822490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL RUSSELL DURYEA Orthodontist 727-785-8847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL Dn0008502) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |