| NPI | 1265704548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATM NURUL AMIN Owner 321-724-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 10430) |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2012-02-02 |