| NPI | 1083037345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMAD CHARKAS Owner 904-345-9413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS038234) |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2014-01-22 |