| NPI | 1538583802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CELIA S MARTIN Owner 386-752-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN19462) |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2014-02-07 |