| NPI | 1285139527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY M ZDENEK Office Manager 386-761-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: FL DN7283) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-08-17 |