| NPI | 1861762411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISSETTE R BERNAL Pediatric Dentist 407-694-8144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN17413) |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2012-01-12 |