| NPI | 1821423617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILA J MAHAJAN CEO 904-423-1377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN13919) |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2013-09-11 |