| NPI | 1902247612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIKA CAVIEDES President 813-672-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: FL DN17483) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental (Licence: FL DN17508) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2013-07-10 |