| NPI | 1902344039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMAD FAWAZ CHARKAS Owner 904-345-9413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: PA DS038234) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2017-02-09 |