| NPI | 1518369115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILA J MAHAJAN Manager/Owner 904-423-1377 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: FL DN13919) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2014-09-25 |