| NPI | 1083999114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORRIN D. MITCHELL Orthodontist 904-766-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: FL DN 6224) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2013-03-27 |