| NPI | 1508255712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW AHRENS President 352-843-0783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL 18985) |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2015-01-13 |