| NPI | 1407257561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK J MOKRIS Owner 407-870-7404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 18060) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2019-12-04 |