| NPI | 1922312354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN W. O'SHAUGHNESSY President 904-273-5570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DN16801) |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2010-07-27 |