| NPI | 1801028592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE ELIZABETH MILLER Administrative Assistant 321-984-7878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 10353) |
| Enumeration Date | 2009-08-14 |
| Last Update Date | 2009-08-14 |