| NPI | 1003276007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMELIA OSPINA Clinical Manager 407-894-3571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2023-03-08 |