| NPI | 1710388269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOCELYN ESPEJO Practice Manager 407-737-7767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN17111) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN19618) |
| 122300000X Dentist (Licence: FL DN20790) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN18209) | |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2015-07-28 |