| NPI | 1336495274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY RAMIRO CORRAL CEO 904-247-0111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN17063) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2012-07-30 |