| NPI | 1861021131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVINA BAILEY Orthodontist 321-543-5812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2020-04-09 |