| NPI | 1386412583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUHA ALJUNEIDI Pediatric Dentist 386-852-0370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2023-12-18 |
| Last Update Date | 2025-05-25 |