| NPI | 1225254220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE ARTHUR KANEHL Owner 904-731-2162 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 6854) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2011-07-27 |