| NPI | 1912126194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REID WALLACE MONTINI President 352-284-2915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DN16790) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |