| NPI | 1114945060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL BROWN President 407-323-5650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 7210) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-08-22 |