| NPI | 1841493186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMI BAHRI Owner President 904-448-9669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 12589) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 12122) |
| 122300000X Dentist (Licence: FL 16187) | |
| 122300000X Dentist (Licence: FL 16828) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2009-02-17 |