| NPI | 1053849646 |
|---|---|
| Doing Business As | LAKE MARY MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | IMRAN A. HAMEEDI Dds/Owner 407-547-1359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2022-04-13 |