| NPI | 1790087138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC RICHARD CLAUSSEN President 407-408-4880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL D17080) |
| Enumeration Date | 2010-11-17 |
| Last Update Date | 2012-06-29 |