| NPI | 1417618463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE KAUFFMAN Office Manager 772-337-4798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2022-01-03 |
| Last Update Date | 2022-01-03 |