| NPI | 1104610617 |
|---|---|
| Doing Business As | SANFORD MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | DANIEL JIMENEZ Chief Operating Officer 407-529-6814 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-04-08 |
| Last Update Date | 2025-04-28 |