| NPI | 1578840245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE I KRAFT Office Manager 386-752-8531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN18804) |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2011-11-09 |