NPI | 1417968686 |
---|---|
Entity Type | Organization |
Authorized Contact | SUE ELLEN ROLANDO Vice Pres 407-898-7401 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN10143) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN10144) |
Enumeration Date | 2006-08-11 |
Last Update Date | 2020-08-22 |