| NPI | 1699432468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN MCDANIEL Owner/Orthodontist 904-640-8599 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-11-29 |
| Last Update Date | 2022-06-08 |