| NPI | 1942031208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT ANTHONY WENK Doctor/ Owner 941-404-8282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2024-08-09 |