| NPI | 1316348956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRALYS M CHARDON Dentist 407-857-9888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN18752) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2014-09-15 |