NPI | 1982082335 |
---|---|
Entity Type | Organization |
Authorized Contact | TIA SHEA SAMMONS Pediatric Dentist 239-776-2115 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN17564) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
Enumeration Date | 2015-05-18 |
Last Update Date | 2015-05-18 |