| NPI | 1912096256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE ARROUET CORNEJO President 863-299-6567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DN15546) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |