| NPI | 1386839439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON COATOAM Office Manager 407-865-6363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN00813) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2007-09-12 |