| NPI | 1336287812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES W. CHURCH Owner 321-453-7047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN-4541) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-08-22 |