| NPI | 1164924494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER VEDAD YADEGARI Ambr 904-521-7981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DN23096) |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2021-10-17 |