| NPI | 1790903888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN MARIE SHERIDAN Dentist 407-351-7083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 16070) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN 9453) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |