| NPI | 1679752638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA L MANSFIELD President 321-723-5244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL Dn14331) |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2010-06-08 |