| NPI | 1073607057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE M CREEL Owner/President 321-723-8821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL dn4076) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |