| NPI | 1245528553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY L VOELPEL Director Credentialing & Compliance 321-724-8398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2011-07-20 |