NPI | 1770859365 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMMY EAGLE Administrator 407-886-2050 |
Organization Subpart ? | No |
Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: FL DN13576) |
Enumeration Date | 2012-03-28 |
Last Update Date | 2012-03-28 |