| NPI | 1346303658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE A. FRAVEL Office Manager 407-656-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL 8872) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2014-05-13 |