| NPI | 1023318052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE L ADRIAN Office Manager 863-644-2408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN5979) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN17195) |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2010-10-25 |