| NPI | 1932682846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE FERRARA Owner 813-229-8090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN18821) |
| 122300000X Dentist (Licence: FL DN15396) | |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2018-09-20 |