| NPI | 1639464852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY WILLIAM HODGINS Owner/Dentist 407-647-1744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 15265) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: FL 15265) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2011-12-16 |