| NPI | 1861814063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ROSE A ALON-ALON President 904-215-2199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: FL 14708) |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2014-01-08 |