| NPI | 1396060430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSIE BOBO Office Manager 407-581-9505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN14384) |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2010-04-01 |