| NPI | 1245381920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN PAUL BAKER Owner 321-267-7072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN0012861) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2009-01-21 |