| NPI | 1821105909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC WARD HODGSON Dentist 321-254-4488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN0009231) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2020-08-22 |