| NPI | 1235432709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN JACQUOT Dentist 407-894-6250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL dn13135) |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2010-12-06 |