| NPI | 1194305250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHNI MALIK SHAH Owner 352-262-4173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-04-13 |
| Last Update Date | 2021-04-13 |