| NPI | 1447796859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YALDA DAVOODI President 352-328-5842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN21376) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN21376) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2017-01-09 |