| NPI | 1023171584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIPAK VRAJLAL SHETH President 863-324-7401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN10392) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 52172) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-22 |