| NPI | 1053420661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW TODD LAGER President 772-878-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 14323) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-08-22 |