| NPI | 1881812311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD LEE STEWART Dentist 321-631-0606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN10171) |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2020-08-22 |