| NPI | 1427219773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRIN YASREBI Dentist 863-667-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN12434) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN5634) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2008-06-19 |