| NPI | 1982863023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADIA N MITCHELL Office Manager 813-677-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN17006) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN14255) |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2008-06-04 |