| NPI | 1174942304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELINE ANN KUZNIA Owner/Dentist 904-278-1175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN15267) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN17936) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-17 |