| NPI | 1013357805 |
|---|---|
| Doing Business As | LAKE NONA FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ALLISON VARNER Credentialing 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2013-06-26 |