| NPI | 1447702071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONDRA AVANT Owner 386-304-4620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN13606) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: FL DN13606) |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2016-10-31 |