| NPI | 1750141271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA G QUARTERMAN Operator 407-761-3144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2024-03-21 |