| NPI | 1851557078 | 
|---|---|
| Doing Business As | LAKELAND PEDIATIRC DENTAL CARE | 
| Entity Type | Organization | 
| Authorized Contact | ANGEL NICHOLS Turstee 863-644-4739  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 122300000X Dentist (Licence: FL 1190925)  | 
| Enumeration Date | 2008-08-07 | 
| Last Update Date | 2008-08-07 |