| NPI | 1275253494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL KHORRAMIAN Owner 727-784-2721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2022-08-29 |