| NPI | 1659815306 |
|---|---|
| Doing Business As | MOUNT DORA MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | THIEN LE Owner 352-270-3015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2022-02-10 |