| NPI | 1053841718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON MARIE BELANGER Business Administrator 407-365-6691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2022-07-21 |