| NPI | 1609408574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN E. MCDANIEL Dmd Owner 850-559-0555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-02-10 |