| NPI | 1972991248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE D CARIDE Credentialing Mgr 727-784-2721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA 011988) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2025-03-04 |