| NPI | 1083383582 |
|---|---|
| Doing Business As | KISSIMMEE CHILDREN'S DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ANDREW WEAVER Practice Administrator 904-395-7772 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2024-11-05 |