| NPI | 1083974901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILIANA M MARSHALL Owner 321-723-2620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN17553) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2013-09-05 |