| NPI | 1851479265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAWVEH NOFALLAH Owner Dentist 863-648-5338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 17075) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2008-09-18 |