| NPI | 1013253061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH BLAKE PELUSO Orthodontist 352-262-9532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA DN1855332) |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2012-12-19 |