| NPI | 1477845865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIDAL SALEM ELIAS Prosthodontist 904-731-2120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN0011583) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2011-05-04 |