| Organization Name: | IMPLANTS, PERIODONTICS & FACIAL REJUVENATION |
| NPI Number: | 1104198282 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TODD MERRELL WILLIAMS (CEO) |
| Mailing Address: | 2346 Creel Ln Ste 101 Wesley Chapel |
| State: | FL US |
| Postal Code: | 335444623 |
| Phone Number: | 8132993867 |
| Fax Number: | |
| NPI Enumeration Date: | 02/03/2012 |
| NPI Last Update Date: | 02/03/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DN012810 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |