| NPI | 1932373636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J. MICHAEL PANCZYSZYN Dentist 386-756-3728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN0009950) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2008-04-15 |