| NPI | 1649590373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE GERRY Owner 904-725-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN14223) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2012-10-23 |