| NPI | 1588950349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE WALTERS Receiptionist 386-758-6050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN 5418) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2011-06-21 |