| NPI | 1992983654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTY J KINARD Secretary 850-785-8574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: FL DN0009234) |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2008-02-05 |